At-home lab tests (also known as home-use kits) have become increasingly popular among busy Americans seeking convenient and reliable health information without having to visiting a doctor’s office or medical laboratory.
At-home lab tests come in two types:
- Self-tests, where you collect a sample of blood, urine, saliva, or another body fluid and process it using the kit’s instructions. The test is performed entirely at home, and the results are available for you to see right away. Examples of self-tests include home pregnancy tests and blood glucose (sugar) tests.
- Self-collection tests also involve collecting your own sample at home, but instead of getting immediate results, you mail the sample to a laboratory for analysis.
In this article, we’ll discuss self-collection tests, also referred to as “mail-in lab tests”, and how they can be applied to your healthcare.
How Mail-In Blood Tests Work
Most mail-in blood tests use a small blood sample collected from a finger prick rather than the larger blood sample obtained from a vein by a phlebotomist at the lab. After collection, the sample is sealed and mailed to a certified laboratory for analysis. Results are typically available through a secure online portal within days.
Besides blood samples, some kits may require the self-collection of saliva, urine, semen, or stool. The collection kits are usually purchased privately online, or some may be available at no charge from local public health programs.
What Kinds of Tests Are Available?
At-home blood and other tests are available for a wide range of purposes. For example:
- Sexual health: Tests for sexually transmitted infections (STIs), such as human immunodeficiency virus (HIV), gonorrhea, syphilis, chlamydia, and hepatitis.
- Fertility and hormonal health: Tests for testosterone, estrogen, progesterone, and ovulation.
- Cancer screening: Screening tests for colorectal cancer using the fecal immunochemical test (FIT), and screening for cervical cancer.
- Infectious diseases: Tests for COVID-19, influenza, and respiratory syncytial virus (RSV).
- Overall wellness: Tests for cholesterol, thyroid function, vitamin levels, and iron.
- Genetics: Documenting ancestry, and screening for certain hereditary diseases.
- Food allergies: Tests that identify immune responses to various foods.
- Substance use: Test panels for drugs of addiction.
How Accurate Are They?
A venous blood draw or sample collection in a medical lab is the gold standard for lab testing. A finger-prick test collects a small sample of blood from the tiny blood vessels (capillaries) just beneath the skin, rather than from a larger vein, as is done during a traditional laboratory blood draw. Because of this, a finger-prick test will be somewhat less reliable, with a greater degree of variation and inaccuracy.
However, a finger-prick sample self-collected at home will do the trick for many blood tests. Studies have shown that most people who take samples at home are able to properly perform the test well enough to provide a usable sample.
Many reputable companies use laboratories accredited under national quality standards, such as CLIA (Clinical Laboratory Improvement Amendments) in the United States (US) or equivalent accreditation systems in other countries. When processed in these laboratories, the analytical testing itself is generally held to the same quality standards as physician-ordered laboratory tests.
For many common blood tests, mail-in testing can provide results that closely match conventional laboratory testing. Studies evaluating home blood collection have found good agreement for measurements such as:
- Hemoglobin A1c (HbA1c, used for diabetes monitoring)
- Total cholesterol and lipid profiles
- C-reactive protein (CRP)
- Certain vitamin levels
- Some hormone measurements
- HIV screening
- Some STI tests
- Vitamin D
- Ferritin
- Thyroid screening
Tips for Safely Using At-Home Tests
Don’t Try To Be Your Own Doctor
Despite their convenience, mail-in tests should not be regarded as a replacement for medical care. Remember that a blood test represents only one piece of the diagnostic puzzle. Physicians interpret laboratory results alongside your symptoms, physical examination, medical history, medications, and other investigations.
Be Careful Interpreting Your Results
A normal laboratory result does not always mean everything is healthy, and an abnormal result does not necessarily indicate disease. False-positive and false-negative results can occur with any laboratory test, including home testing. These incorrect results may lead to unnecessary anxiety, additional testing, or delayed medical evaluation. Be very careful about making a self-diagnosis on the basis of an at-home kit. Always follow up with your healthcare provider for any positive or concerning results.
Choose a Reliable Test
The FDA strictly regulates at‑home lab tests to ensure safety and accuracy. There are many companies that offer unlicensed, potentially unreliable tests. Some such companies may make dramatic claims about the accuracy or diagnostic abilities of their test. Buying a test from a reliable company, discussing your test with your doctor before buying, or obtaining your test from Public Health can ensure your safety. As well, you can check any specific test on the FDA website to see if it is FDA-approved.
References
Centers for Disease Control and Prevention (CDC)
US Food and Drug Administration (FDA)
PLOS One medical journal
US National Library of Medicine
