At-home lab tests are growing in popularity and availability. Here’s help navigating the options.
Wish you could skip the hassle of going to your doctor’s office to find out if you’re low on vitamin D or have a sluggish thyroid? You’re in luck. These days, you don’t necessarily need a doctor’s script to test things like your thyroid hormone levels or nutrient status. At-home tests enable you to check up on your health on your own terms.
At-home lab tests, sometimes called direct-to-consumer tests, are ones marketed and sold directly to you (without involving your doctor). They’re commonly available online and are allowed in the majority of states in the USA.
Some at-home tests use a small finger-stick blood sample. Others may use samples of your pee, poo, or saliva or a swab of your nose or cheek. You can collect these samples yourself using the materials provided in a test kit. Typically, you then ship your samples to a designated lab (or a company that acts as a middleman), where they can be tested for a broad array of health markers.
New at-home testing models are emerging, though. On the cutting edge is Vessel Health, which recently launched a wellness test in which you pee on a high-tech test card and use a smartphone app to read your results within minutes. It currently measures about a dozen health parameters, like your hydration status, ketone production, and magnesium level.
“Our wellness test is truly an at-home test,” says Jon Carder, CEO and co-founder of Vessel. “In many cases, an at-home test just means you’re collecting your sample at home. Then you have to mail it to a lab and wait three to five days for your results.”
You can choose different at-home tests based on what you want to know about your health. Here are several types.
The at-home DNA health test from 23andme.com looks at your genetic risk for developing certain diseases. Other genetic tests could help guide your healthy lifestyle. For example, the test from genopalate.com may help predict the best foods for you.
To find out if you’re low on certain vitamins and minerals, choose a test that measures the nutrients you’re interested in, such as B vitamins. These tests are available from sites like vesselhealth.com and everlywell.com.
Microbiome tests use a poo sample to identify the types and amounts of good and bad bacteria in your gut. The test from biohmhealth.com also assesses your mycobiome—the fungi that can impact your health.
You can screen yourself for conditions like low thyroid function or sexually transmitted diseases, thanks to at-home tests from sites like everlywell.com. Be sure to read the test instructions carefully so you’re aware of factors that could affect your results.
“There are good-quality direct-to-consumer tests available,” says Kara Fitzgerald, ND, director of Sandy Hook Clinic in Newtown, Connecticut. “But they’re interspersed with ones that aren’t as good.” Do some sleuthing before you buy.
Mahmoud Ghannoum, PhD, co-founder of BIOHM Health, advises checking on the scientific rigor behind tests. For example, were they developed using validated, state-of-the-art technology? Visit a company’s website for details. If a company claims its lab test technology is a trade secret, that’s a red flag.
You can also check for lab certifications and government approval, but the requirements vary. The FDA typically doesn’t review at-home tests designed to support general wellness or ones that have little impact on medical care. But FDA clearance is required for genetic tests that look at your risk of developing diseases.
Also, many at-home tests use labs that are CLIA (Clinical Laboratory Improvement Amendments) certified. This provides some reassurance in terms of the accuracy and reliability of your test results. “When I founded Everlywell, I partnered with CLIA-certified labs across the country who were already running these kinds of tests for doctors’ clinics,” says CEO Julia Cheek.
At-home genetic tests may be especially tricky to navigate. Look at how clearly the results are communicated and how comprehensive the test is for health conditions of interest. You can typically review a sample test report online.
“At-home genetic tests may only look at a few variants in your DNA that can increase your risk for breast cancer, for example,” says Sara Riordan, a certified genetic counselor and president-elect of the National Society of Genetic Counselors. “In contrast, doctor-ordered tests may look at entire genes or a whole panel of genes involved in breast cancer risk.” These give you a clearer picture of your risk.
Riordan says a genetic counselor can help you evaluate at-home genetic tests before you buy. Visit findageneticcounselor.com, and check with your insurance company about coverage for this service.
Read companies’ privacy policies to gauge the risk to your personal data. “A company should be transparent about how they will protect your genetic data and your personally identifiable information, like your name and address,” says Riordan. “They should also disclose if and how they will share this information with third parties.”
For example, an at-home genetic testing company might sell your data (without personally identifiable information) for research or drug development purposes, says Fitzgerald. That helps keep the cost of the test relatively low for you. But you need to think about whether you’re comfortable with that.
Riordan says a federal law prohibits health insurance providers from using genetic information to decide whether you’re eligible for coverage. But that doesn’t apply to other types of insurance, including life insurance. You may be asked about genetic test results on your application, which could affect your eligibility or insurance cost.
At-home testing isn’t necessarily the best option in every situation. Here are some questions to help guide your choice:
Some tests, such as a microbiome test, may not be offered by your doctor. An at-home test could be helpful in that situation. An at-home test could also be handy if you want more frequent monitoring of certain health markers, such as your hydration or vitamin D level.
That said, it’s generally wise to share at-home test results with your health-care providers. This keeps them in the loop and helps you take appropriate actions based on your test results.
At-home testing has grown rapidly in the past few years, and experts predict it will continue to expand. “I think that as consumers dictate that they want to be in the driver’s seat of their health care, direct-to-consumer testing is going to grow even more robust,” says Fitzgerald.
Plus, companies are reporting that at-home tests have received new interest during the COVID-19 pandemic.
“We’ve certainly seen a lot of people become aware of at-home lab testing since the pandemic has made it difficult to go to the doctor,” says Cheek. “And now that many folks have tried it, they’re telling us they don’t want to go back to the old system, which is frustratingly outdated in terms of accessibility and convenience.”
At-home testing for COVID-19?
Yes, you may be able to test from the comfort and safety of your couch. The FDA has granted Emergency Use Authorization (EUA) during the pandemic to allow certain COVID-19 (coronavirus disease) tests that let you collect a sample of bodily fluid at home and mail it to a lab for analysis.
As of press time, some companies, including Vessel Health, are working on getting EUA for at-home coronavirus antibody tests. These would use a finger-stick blood sample to check for a past infection.
An antibody test may be useful if you suspect you’ve already had COVID-19 but aren’t sure. Just remember, it could take one to three weeks after you’re infected with the coronavirus for antibodies—proteins your body manufactures to fight a specific infection—to be detected. If you have the antibodies, it’s currently unclear if and for how long that might protect you from future infection.
Men’s health across the life course
Theodore D. Cosco, PhD (Cantab) CPsychol