Whether you’re new to the idea, or a seasoned veteran (hello, global pandemic), there’s a lot to know about at-home lab tests. The issue of most importance with these tests, however, is their accuracy.
Takeaways:
- While in-person lab tests are the gold standard, at-home tests are an excellent substitute for the majority of people.
- Not all at-home tests are created equally; pay attention to quality measures.
- At-home tests are a convenient way to learn what lifestyle changes can actually improve your health.
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What are the differences between at-home testing and in-person lab visits?
The main difference between lab testing and at-home testing is the location! One is done from the comfort of your own home like Gabby Lopardo did, or Brendan Fallis; the other is done at a lab testing center.
Traditional lab tests involve making an appointment, getting yourself to the center, and potentially waiting in line until the next technician is ready to take you. Then you have to wait for the doctor to receive the results, interpret them, and call you back to discuss them. Testing centers keep all their supplies in one place, so if you need a urine test, a saliva test, a blood test, or a tissue test, you can go to one place to have it all done. Your doctor may order any one, or combination, of these tests as a routine checkup or to check out anything fishy going on with your health.
With at-home testing, you skip the whole process of making an appointment, going to a testing center, waiting in line, waiting on the results, and waiting on your doctor to contact you. At-home testing should not replace doctor’s visits, but they can help you gain a greater sense of control over your health. At-home tests can give you the in-depth information you need on your hormone, vitamin, or glucose levels (among many other biomarkers) to guide you on what lifestyle changes you might want to make to optimize your health. They can also alert you to any early-stage illnesses you may have before they get worse.
For example, you might notice you feel extremely fatigued mid-afternoon and wonder what could be going on. With an at-home test, instead of going through the hassle of heading to a brick-and-mortar testing center, you’ll be mailed a testing kit to send blood, saliva, or urine samples to a CLIA-approved lab for analysis. In a matter of days, you’ll have lab results that’ll give you direct insight into changes you can make to get rid of that mid-afternoon tiredness!
Is one type of testing more accurate than the other?
At the end of the day, the gold standard for lab tests is going to the lab center to have vials of blood drawn. This type of testing is especially important for people with rare conditions or extreme illnesses that need close monitoring. For the majority of people, though, at-home lab testing provides an appropriate level of accuracy and can be an effective way to gain a greater sense of control over your health and to make changes that actually impact your well-being.
As Dr. Murdoc Khaleghi, the founding Chief Medical Officer of Base, explains in an interview,
‘A [lab-test] result might be 4.09 instead of 4.1, there might be that variation. But you’re still seeing if your results are in the low or high or optimal range… That’s what’s great: You get the value of the convenience of home-testing while still having meaningful-enough information that you know how to act accordingly.’
The differences between at-home and lab center lab tests are minimal or insignificant for most people. And at-home tests have traditionally been in use for countless people including newborns, young children, and people who just can’t get a regular blood draw for whatever reason. Furthermore, at-home tests undergo rigorous testing, to ensure fraud is not taking place and that your results are accurate.
Are all at-home tests accurate?
Not all at-home tests are created equally.
Many variables can impact the accuracy of an at-home test, including the quality of the test sample, the type of test sample, which testing method is used in the lab, and the quality of the test kit. Any one of these factors could impact the outcome of your lab results, which is why it is important to be picky with which at-home test you choose to use.
The Theranos horror story is a great example why it pays to pay attention to which companies you choose to work with. In its beginnings, Theranos seemed like a promising company that was going to revolutionize some aspects of convenient lab testing. But as time passed, and millions of investor dollars later, it was discovered the company was deeply fraudulent.
The Theranos case helped push the government to find a way to prevent future lab-testing fraud, especially since it involved and potentially jeopardized the health of many Americans. Today, reputable companies go the extra mile to provide reassurance about the quality of their tests. There are two main features to look for to determine if an at-home test is worth your time: CLIA-lab certification and CAP accreditation.
- Started in 1988, the Clinical Laboratory Improvement Amendments (CLIA) instilled federal standards to apply to United States centers that test human samples for the purposes of diagnosing, preventing, or treating disease. This initiative is supported by the CDC and the FDA.
- The College of American Pathologists (CAP) Laboratory Accreditation Program strives to keep lab testing facilities up-to-date by maintaining a stringent set of quality standards. These efforts help to ensure accurate results, labs to manage technology changes effectively, and keep laboratory staff sharp by providing continuing education opportunities.
So, while a needle-in-the-arm lab test is the ultimate gold standard, this may not always be realistic for you. If you’re like most people, you’ve got a busy schedule to keep up with. And despite that busy schedule, you probably still want to get to the root of what’s been impacting your mood or your libido (or whatever ailment is plaguing you). At-home tests can be an excellent solution to your situation; just look for tests that have CLIA certification and CAP accreditation (which you’ll find with Base tests).
Are at-home saliva tests also accurate?
As mentioned above, it is important to make sure a saliva home-test kit is certified and accredited for accuracy. With that in mind, saliva can actually be a better test than blood in some cases, particularly for hormones; this is because hormones are often bound to protein and inactivated in your blood. The free and active forms of certain hormones are often found in higher quantities in the saliva, such as cortisol, melatonin, estrogen, and testosterone.
At-home saliva testing is particularly convenient for a number of reasons, including its noninvasive and painless nature. If you haven’t already, you’ve likely heard of people sending in spit samples to learn about their DNA and ancestry. And in 2020, at-home saliva tests were used to help vulnerable populations, such as the elderly, safely learn if their symptoms were related to COVID-19. Aside from these uses, saliva testing is more often used to measure hormone levels.
Depending on the hormone you’re trying to track, the time you collect your sample may impact your test results! Cortisol, for example, spikes when you wake up and tapers down as the day goes on. If you’re feeling stressed out, it may be better to test your cortisol level in the afternoon or evening to see if it is remaining elevated instead of going down. Another example from Dr. Khaleghi in an interview:
‘…we all know our blood sugar is different from one moment… [to] another. If you test it two different times, you’re gonna get a different number. That’s actually true for most biomarkers, where the only difference is the degree of the variation… of time course.’
Other things that can decrease the accuracy of at-home saliva tests include eating, drinking, or smoking around the time the sample is collected and other sources of cross-contamination. To avoid contaminating your sample, closely follow the instructions provided in the test kit. To get the purest sample possible for your test, for at least 30 minutes before collecting a sample, do not
- Drink,
- Eat,
- Brush your teeth,
- Chew gum, or
- Smoke.
Benefits of at-home testing
As long as you’re using certified and accredited test kits, the benefits of at-home testing only get better from there!
- Convenience: Avoid the hassle of seeing a doctor, getting a lab test prescription, going to the lab, having the test done, waiting on the results, then speaking with your doctor again, then creating an action plan… (that was tiring just typing all that up!). Instead, learn what your cortisol levels (or any other levels) are doing from the comfort of your home.
- Control: Learn what may be impacting your health on your own time and in your own way. With at-home tests like Base, you’ll get personalized recommendations for ways you can improve your nutrition, supplement, or lifestyle habits based on the results of your at-home tests. This gives you more power to make changes in your life that actually work for you.
- Monitoring: Make changes to your eating and lifestyle habits and see the direct impact they have on your lab values by monitoring them over time. If you learn you have low vitamin D levels at the start of winter, you can see if taking cod liver oil or another dietary change improves your vitamin D when you test again the next month. If your levels don’t improve, you might decide to go for a supplement (or to take a trip to a warmer, sunnier place to soak up that sunshine).
- Revolutionary: Be on the cutting-edge of where healthcare is headed! The future is promising in terms of healthcare improvements, and that includes at-home testing, personalized nutrition, and data-driven care.
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