Have We Taken At-Home Health Testing Too Far?

Fitness

Cropped shot of young Asian woman consulting to her family doctor online in a virtual appointment, holding a medical test tube, conducting Covid-19 diagnostic test at home

Curious about your sensitivity to certain foods? Wondering if your thyroid levels are what’s suddenly making you so tired? Or maybe you’re dying to learn more about your gut microbiome? There’s an at-home test for that. With a few clicks, a mid-sized rectangular box can be delivered right to your doorstep with all the materials you need to gather your saliva, blood, or urine and ship them back to a lab, which will analyze them and send you a comprehensive health report — sometimes alongside personalized recommendations for living your best life. But are these DIY preventive tests all that they claim to be?

Home health tests have been around for several years, and every year, more options seem to appear, from comprehensive blood panels to microbiome assessments. It’s easy to see the appeal: DIY-ing health testing means people can skip spending hours of their day at a doctor’s visit, and they may even offer an affordable alternative to seeing specialists for those without adequate insurance. And while experts agree that at-home preventive testing does have its place, they also caution that the DIY route isn’t always the best, or the safest, bet when it comes to your well-being. Here’s what to know about at-home preventive testing.

Why Try an At-Home Test?

Depending on your goal, an at-home health test may make sense. For example, Greg Sisengrath, an ultramarathoner from Texas, used a DIY-blood test to get information about his health before racing his first 100-mile race, hoping to make sure he was in good shape before the physically demanding event. The 48-year-old used a test called InsideTracker, a program that uses comprehensive blood tests, DNA, and reported lifestyle habits to recommend where you can optimize your health. You get your blood drawn at a lab or at home via a mobile phlebotomist, then send it to InsideTracker for analysis. Within 5 to 7 days you’ll receive results with food, supplement and lifestyle recommendations specific to your body — depending on which test you choose — via the company’s app.

“I never would have thought that I would need to supplement vitamin D with the amount I spend outside.”

InsideTracker alerted Sisengrath to a big problem: his iron levels were too high, a condition that increases the risk of heart and liver damage. He’d been supplementing with iron on his own without actually knowing if he needed to, and ended up overdoing it.

He also found that he was vitamin D deficient, which came as a surprise since he spent a lot of time outside in the sun while running. But the test taught Sisengrath, who is Asian American, that people with darker skin tones often have a harder time absorbing vitamin D from sunlight, making supplementation especially important. “I never would have thought that I would need to supplement vitamin D with the amount I spend outside,” he tells POPSUGAR. “I appreciated that this test was more all-encompassing in terms of results and recommendations compared to those I’d previously gotten from a doctor.”

These tests range in price from $149 to $699 based on whether you choose to simply get your results uploaded through the brand’s software, or the comprehensive kit with customized recommendations. Sisengrath calls the cost one of the main drawbacks of the test, but consumers may be able to use HSA or FSA funds to cover it.

For endurance athletes hoping to test themselves for nutrient deficiencies, at-home tests can be super useful and convenient, says Kelly H. Woodward, DO.

They can also be convenient for those living in rural areas, or elderly or homebound people, adds Soma Mandal, MD, a board-certified internist at Summit Health in New Providence, New Jersey. “Not all patients have the fortune of living close by to a medical center or doctor’s office, and at-home medical testing can allow patients to collect their samples in the comfort of their own home and eliminates the need for multiple visits to a healthcare facility,” she says.

Another instance in which at-home testing could have advantages is when screening for sexually transmitted infections, which some people may be more comfortable testing for in the privacy of their own home, Dr. Mandal says: “This can actually help with improving screening efforts for STIs.”

The Other Side of At-Home Testing

While home health tests can be convenient and useful in certain cases, they also carry risks that consumers should consider. For one, not all at-home tests allow you to discuss your results with a physician in real time, and that can be a problem.

“There is a risk when you have information without the ability to have it interpreted by a medical professional, that it might cause unnecessary anxiety,” says Leilani Valdes, MD, medical director at Regional Pathology Associates and chair of pathology and laboratory medicine at Citizens Medical Center in Victoria, Texas. “[A good rule of thumb is] don’t order a test if you don’t know what you’re going to do with the results.”

And while it can sometimes seem as though more information is always better, that’s not the case when it comes to health testing. Healthcare providers order specific tests based on individual risk factors and a tailored assessment of that patient. By not consulting with an expert to start, you may end up needlessly testing yourself for non-applicable conditions, Dr. Valdes says.

“In hindsight, I wish I’d just gone straight to see a doctor rather than take this test, which has a lot of room for error.”

For instance, when Sara Hudgens, 38, an experienced marathoner living in Texas, developed GI issues, she turned to the EverlyWell Food Sensitivity Comprehensive Test, which uses a finger-prick sample to test reactivity to 204 foods, before visiting a doctor.

Not only did the process take longer than she expected, because she had to retest herself after failing to collect the requested number of samples with her first kit, but the test also didn’t reveal any food reactivities, besides a mild sensitivity to eggs.

Hudgens ended up visiting a functional medicine specialist for additional testing, and learned she was deficient in B vitamins and had abnormally elevated levels of cortisol, the stress hormone. The doctor determined that Hudgens’s stomach issues were more likely due to existing stress and anxiety than her nutrition.

“In hindsight, I wish I’d just gone straight to see a doctor rather than take this test, which has a lot of room for error,” Hudgens says. “For the price of what tests cost and the hassle that it ended up being, it wasn’t worth the potential convenience.”

Dr. Woodward notes that Hudgens’ case demonstrates why starting with a conversation with your doctor can be crucial in ensuring you’ve picked the right test. Food sensitivity and allergy diagnoses are an area where you would want a lot of professional input, he says.

Thyroid testing is another type of at-home test that can be overused, Dr. Woodward says. “In my experience, many people are unnecessarily and repeatedly checking their thyroid function for subtle findings that cannot be manipulated to benefit their health and well-being,” he says.

Dr. Woodward also warns against trying to diagnose conditions or perform genetic testing through tests like AncestryDNA and 23andMe. Test results may not be reliable and can be difficult to interpret without personalized expert guidance, he says. Just imagine learning from a direct-to-consumer DNA test that you have genetic indicators for an increased likelihood of diseases, like Alzheimer’s disease, with zero personalized guidance on how you interpret and manage that risk.

Genetic markers are only one piece of your total risk, he notes. “Without professional consultation, you may get inaccurate, commercially biased and/or irrelevant information on risk mitigation and disease management,” Dr. Woodward says. “You may also need personalized guidance from a professional on current screening guidelines for diseases of concern, specific lifestyle modifications and, occasionally, medications and/or supplements that can help you.”

What to Prioritize When It Comes to Preventative Care and Home Testing

If you decide to use an at-home test, consider these caveats.

First, if possible, talk to your doctor about your concerns. If you have specific health questions you’d like answered, your provider should be your first line of defense.

Then, determine whether the test you’re using is FDA-approved. Many aren’t, Dr. Valdes says (none of the aforementioned tests are). “Anything that’s not FDA-approved should have that information clearly disclosed, along with recommendations on what consumers should do with the information they get back,” Dr. Valdes tells PS. If a test doesn’t clearly state whether or not it’s FDA-approved, or is not FDA-approved and doesn’t give guidance about what to do with any results you receive from the test, skip it.

If you move forward with a test, plan to go over your results with a doctor soon after you receive them. This will help manage and eliminate any post-results anxiety or confusion and you can work with a healthcare provider to determine next steps, if any.

Also consider your potential emotions if you get unexpected results back. Maybe that means inviting a friend or loved one over to read the results, as well as talking to a doctor.

Above everything, providers emphasize prioritizing basic habits to promote a healthy lifestyle, including eating a balanced diet, exercising regularly, and getting enough sleep. Additionally, Dr. Valdes recommends staying on top of all screening that’s available to you based on your individual demographic, family history, and other risk factors, which may include mammograms or flu vaccines. For the uninsured, Dr. Valdes says that there may be community resources such as clinics for low-income patients that could help you bring down preventive healthcare costs.

Ultimately, none of our experts deemed at-home tests necessary when it comes to being proactive about preventative care. When used correctly, they could provide useful information about your health — but they shouldn’t be your first line of defense, and they shouldn’t replace regular doctor’s visits either.

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