Too often, home medical tests yield false positive results. Still, these tests are appealing because of their ease and convenience. Want to avoid a colonoscopy or check for thyroid disease or high blood sugar? From the comfort of your own home, you can find important health information through swabs, sticks, poops and pee. But you may not be able to interpret the results or get reliable readings, doctors say.
Still, many Americans use them, especially older Americans. The University of Michigan’s National Poll on Healthy Aging recently found that three in four adults ages 50 to 80 believed home tests were more convenient than going to a doctor or health care provider.
Many people became familiar with home testing during the pandemic, when they tested for the coronavirus, said Matthew Weissman, a professor of internal medicine and pediatrics at the Icahn School of Medicine at Mount Sinai in New York. But screening for other conditions is often more complicated.
“It’s great in the sense that it saves office visits,” Weissman said. “But usually there’s still some intervention from a physician,” whether it’s prescribing medications or helping you interpret data.
According to Michael Hochman, an internist in Long Beach, California, home tests could be especially helpful for the thousands of Americans who can’t see a doctor.
Whether it’s via telemedicine or not, home testing is most effective when done with your doctor’s knowledge, Pochapin said. “You need to tell your doctor, ‘I’m thinking about doing this test. Is it appropriate?’” he added.
But that may not be the case. According to Jeffrey T. Kullgren, MD, director of the National Poll on Healthy Aging at the University of Michigan, only 55 percent of those who bought and used an at-home test for infection shared their results with their primary care physician. “This suggests that older adults are using these tests as a substitute for a doctor’s visit,” Kullgren said.
Most home tests can be purchased online or at your local drugstore. Only a few are covered by insurance. We asked doctors about the effectiveness of a few commonly available tests:
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Urinary tract infection:
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Method: You urinate on a strip (or in a cup and dip a strip in the urine).
Cost: Approximately $11 (not covered by insurance).
What to know: “They’re basically testing for things that are associated with UTIs, like nitrates and leukocyte esterase, two things that are often seen with UTIs,” says Ivan Grunberger, director of urologic strategic initiatives at Lenox Hill Hospital in New York. But it’s not the same as having your urine cultured to determine which antibiotic will best fight your infection.
Who is it most suitable for: “It is not a big deal for people who often have infections, know their symptoms and have responded to antibiotics before, to take a test at home and then contact their doctor.”
Method: Pee on a test strip for five days in a row, reporting your results to an app that collects other data from you. Sign up to receive your results.
Cost: Approximately $20 (not covered by insurance).
What to know: Menopause tests promise to tell users whether they are in perimenopause, a stage just before menopause. Manufacturers claim that the product helps improve communication between users and doctors, but most doctors say there is no correlation between urine hormone levels and symptoms.
Who is it most suitable for: Many doctors say the tests aren’t helpful for most women. “This single test is not going to diagnose you,” said Asima Ahmed, chief medical officer and co-founder of Carrot Fertility, a global fertility benefits platform. “It’s really important to look at all the factors and then discuss those results with a menopause specialist or someone who treats women in menopause.”
Method: Collect a stool sample. For the stool DNA test called Cologuard, which looks for DNA changes and small amounts of blood that pass through the stool, you’ll need to send it to a lab. Results take about two weeks. A fecal immunochemical test (FIT), such as Second Generation, looks for hidden blood in the stool. For this, you’ll need to collect a stool sample and add a solution to it, and you’ll have results in minutes.
Cost: A FIT test can cost between $30 and $120 and is sometimes covered by insurance. Cologuard’s $500 test is covered by most insurance plans but must be prescribed by your doctor and may require a co-pay or deductible. Some private insurance plans cover both home tests, but if you have a positive result, your follow-up colonoscopy may not be covered because your insurance considers home testing a screening procedure.
What to know: “When patients want to do these tests, I tell them there’s a possibility that it could be a false positive,” Pochapin said, adding that the tests detect blood in the stool, which can be caused by conditions other than cancer. “So if it comes up positive, it doesn’t mean you have cancer.”
Who is it most suitable for: Pochapin added that the tests are intended for healthy individuals who do not show symptoms. If you have rectal bleeding, do not use a home test; instead, see your doctor immediately, he said.
MethodPrick your finger to collect blood and send it to a lab for results. It takes about two weeks to get the results.
Cost: From $49 to $150. Some insurance plans will reimburse.
What to know: The accuracy of the tests may not be as reliable as your doctor’s. And the results must be interpreted carefully. “A1C is a three-month average of blood sugar. If someone is checking it every week, every month, every day, for example, and doesn’t realize that those gradual changes are not really something you should be using to guide your management, it could be harmful or potentially fatal,” says Michael B. Natter, an endocrinologist at NYU Grossman School of Medicine.
Who is it most suitable for: If you have diabetes, this can be a useful tool to track your blood sugar levels. However, you should never change your insulin or diabetes regimen without first consulting a doctor.
Method:Depending on the kit you purchase, you can go to a lab to have blood drawn and then receive the electronic results through an app, or you can prick your finger and collect blood that you send to a lab.
Cost: $50 to $500, depending on the number of allergens you measure. Insurance usually does not pay.
What to know: “Allergy tests have a high rate of false-positive results,” says Eric M. Macy, a fellow of the American Academy of Allergy, Asthma, and Immunology and an allergist at Kaiser Permanente Southern California. “You would be wasting time, effort and money trying to avoid irrelevant allergens.”
Who is it most suitable for: You could use the test for a specific allergen, like cat hair, Macy said. But, he added, “You could also easily, and more cheaply and accurately, find out that you’re allergic to cats by petting your cat and then rubbing your eyes or nose, because the cat allergen is on the fur and one of the sources is cat saliva.”
Method: Prick your finger to send blood to a lab for results in about a week. Most of these tests look for various biomarkers associated with thyroid disease.
Cost: From approximately $21 to $235. Typically not covered by insurance.
What to know: “I don’t know if I would trust it,” Natter said. “I think it’s a little premature. It opens the door a little bit for potential harm if patients feel empowered to self-manage and that could lead to more drug abuse and miscare.”
Who is it most suitable for: ““If you really don’t know what your biochemical status is, in terms of your TSH or your free T4, then it can be helpful to have that access at home,” Natter said. “But it has to be done in conjunction with a health care provider to make subsequent management decisions based on that data.”
The FDA has created a list of reliable home tests, but doctors still advise caution. While home tests can be useful and convenient, it’s important to remember that a number of variables, including the lab performing the test, can affect the quality of the results, said Donald Karcher, president of the College of American Pathologists and a professor of pathology at George Washington University Medical Center.
It’s important to follow the instructions exactly as they’re written, and to make sure you’ve collected the sample correctly, he said. “Not every home test is created equal,” Karcher said.