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Are Home Diagnostic Tests A Waste Of Money? Experts Weigh In

Are Home Diagnostic Tests a Waste of Money?Mai Ly Degnan

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Mai Ly Degnan

It used to be that if you had a niggling health concern, you'd see your doctor and talk things through. That doctor might, or might not, order further testing for you—a blood panel, say, that would involve getting pricked with a needle at your local Quest Diagnostics.

It sounds a bit antiquated, doesn't it? These days, you can order a home test for everything from colon cancer to food sensitivities, sexually transmitted diseases (STDs) to celiac disease. Worried about your thyroid levels? There's a kit for that. Wondering whether your waning libido means you're in perimenopause? Ditto. Even if you don't have any health issues, it takes just a quick scroll to be persuaded that you do—because your favorite influencer is plugging a microbiome testing kit, or an ad promises that a continuous glucose monitor will solve your midafternoon slumps.

Business is booming for the at-home diagnostic test kit industry, which pulls in more than $5 billion a year—a number that's predicted to double by 2032. Everyone wants in on the action. In addition to the slew of online companies that have popped up, Labcorp now offers home tests via Labcorp OnDemand, and CVS and Amazon offer DIY tests for kidney disease, diabetes, and heart health. We're sending off samples of blood, mucus, saliva, poop, and urine, but just how accurate—and how regulated—are these kits? And should we really be paying anywhere from $10 to $1,000 out of pocket for tests that might be covered by insurance if a doctor did them? Here's the full picture.

The Upside

For many, the appeal of home testing is not having to go through a doctor. Patients are often tired of leaving appointments without answers, so with Google at their fingertips, they're taking matters into their own hands. According to research, around 1 in 7 doctor-patient encounters end in diagnostic error, and last year, the hashtag #MedicalGaslighting took social media by storm, with over 262 million TikTok views.

"It's very hard for some patients to convince their doctors that they actually need certain testing," says Michelle Sands, a naturopathic doctor and author of Hormone Harmony Over 35, whereas "after an at-home test, they can go in armed with information. Even if the doctor wants to order another test to verify, at least the patient is being heard and not being told, 'You're 50 now, everyone's tired.' No one is going to care about your health more than you do."

Another major plus of home testing is that it can increase access to care. There are 121 million Americans—that's 37 percent of the population—living in healthcare deserts, meaning they struggle to access basic services such as primary care providers, pharmacies, and hospitals. For them, home testing can be life-changing. And for the 8.4 percent of Americans who don't have health insurance, home tests may be cheaper than an out-of-pocket trip to the doctor's office.

According to Gabriel Gaviola, MD, a Harvard Medical School instructor and senior medical director at Everlywell, a company that specializes in at-home diagnostic health tests, "another benefit is that it provides a layer of privacy for those who may not be comfortable visiting their provider in person. That's especially true for things like sexually transmitted infections." Everlywell offers a test that screens for six STDs at once for $169—which may or may not be worth it for people hoping to avoid a toe-curling experience with their longtime family doc.

The Downside

The biggest one is that you're paying out of pocket for a test that might otherwise be covered by insurance, which could be more expensive than the co-pay for a doctor's visit. Second, many doctors will want to order a retest of results from a lab they don't know because they have concerns about the quality of the test or may prefer a different modality of testing. Brian Blank, MD, a family medicine physician based in Greenville, South Carolina, often sees patients who have shelled out for saliva-based hormone testing, which he has found is less accurate than blood work. "Patients usually take some convincing that the better way is to do the blood test, because oftentimes they've paid a lot of money for this kit, and they've watched somebody promoting it online," he explains. "I tell them that we really need to take those results with a grain of salt."

There's also room for user error. Just as you can screw up a home COVID-19 test, you can screw up a potentially expensive diagnostic test kit. "Patients might not follow the directions correctly or take it at the right time, so they get a false negative or false positive," says Sands. "That's where home kits can get a little bit iffy." She also recommends talking through the results with a doctor, as results can easily be read incorrectly.

How to Choose a Test Kit

The FDA has approved home tests for HIV, urinary tract infections, vaginal yeast infections, COVID-19, and flu. Home tests for colon cancer, such as Cologuard, are "considered a really upper-level test," says Blank. Although they're not quite as effective as colonoscopies and do need to be repeated more frequently, they are a highly effective diagnostic test. In fact, the UK's National Health Service sends one to all residents (who are registered with a GP and within the at-risk age group) every two years as a prescreen for a colonoscopy.

Generally, though, regulation around the industry is lax. The FDA doesn't review what it classifies as "wellness tests," meaning any test that doesn't set out to diagnose a specific condition (we're talking tests that claim to measure stress or hormone levels, food sensitivities, cellular aging, or the levels of vitamins in your blood). There's also the loophole that most tests made and analyzed in a single lab (known as laboratory-developed tests, or LDTs) don't undergo the same strict FDA reviewing system as ones from mainstream manufacturers. Home tests? You guessed it—many are LDTs.

However, certain markers will tell you whether a test is high quality. Gaviola advises sticking to ones that are CLIA-certified (CLIA stands for Clinical Laboratory Improvement Amendments, which are U.S. Federal regulatory standards). "The second level of certification, which is a little bit more robust, is a CAP [College of American Pathologists] accreditation," he notes. Companies with either seal of approval are likely to tout them in their marketing materials. You can also check if a particular test is cleared by the FDA by searching its database of approved home and lab tests.

And Last, Skip These Tests

While some home tests can give you data to discuss with your doctor, others are a waste of effort and money. Don't bother with...

Popular food-sensitivity tests that work by checking a blood sample for the immune system antibody IgG. According to the American Academy of Allergy, Asthma & Immunology's site, "This test has never been scientifically proven to be able to accomplish what it reports to do. The scientific studies that are provided to support the use of this test are often out of date or in non-reputable journals."

Tests for fertility hormones such as AMH. It's better to get this tested by your doctor as part of a battery of other diagnostic tests. Even though these tests are sometimes called "egg timer tests," AMH alone is not a good measure of either the number or quality of your remaining eggs.

Menopause-predicting tests. These monitor levels of hormones such as follicle-stimulating hormone (FSH), which fluctuate regularly, rendering results inaccurate. "A woman who's clearly postmenopausal doesn't benefit from the test because it's not giving you new information," says Lauren Streicher, MD, an ob-gyn and certified menopause practitioner of The Menopause Society. "A woman who's perimenopausal doesn't benefit because it's completely inaccurate—it won't tell her how soon she'll be postmenopausal. The third category is younger women who are worried that they're perimenopausal because they're struggling to get pregnant. If a home test catches them when they're ovulating, their FSH will be high, and they'll think, Oh my god, I'm never going to get pregnant. But instead of doing that test, they should have been home having sex," says Streicher.

Any sort of testing that pushes products on you. "You never want to take a test from a company that also sells a bunch of supplements that go with the test results," says Sands.

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