In recent years, a variety of at-home health test options have become available for people to use at home. These at-home testing services may appeal to people for a variety of reasons. In some cases, at-home testing can ensure that individuals are empowered with the diagnostic knowledge to make informed decisions on their care.
Why might people rely on at-home health testing?
Many people face anxiety and stigma when pursuing important medical care, leading them to avoid seeking care for certain tests. Others may turn to at-home testing due to concerns of the cost of in-office medical testing, inability to find a primary care provider, long waits at the emergency room or urgent care, among other reasons. Some conditions, such as the need for recreational drug testing, can also carry stigma, and may lead some to pursue at-home testing as opposed to laboratory testing. Other tests can help make decisions about health conditions, such as the importance of COVID-19 tests in identifying positive results and stopping the spread of illness. No matter the reason, at-home tests help providers “meet patients where they are” and encourage participation in their own medical care.
What are the drawbacks of at-home testing?
At-home testing does not deliver a definitive diagnosis. To receive treatment, people must confirm these results with their health care provider. These tests should never replace an in-person evaluation with a health care provider. Many times, the results of at-home testing will point towards additional medical care. At-home tests stand as a useful vehicle to convince people that their condition or status is worthy of medical attention.
Each at-home test comes with its own specific counseling points. Speak with your provider or pharmacist about the key points associated with a specific at-home test before use.
What are some types of at-home health tests?
There is a wide range of testing available on the market. Here are some of the most common or frequently used tests.
Pregnancy and Hormone Testing:
One widely known home test is the tried-and-true pregnancy test. These urine sticks test for human chorionic gonadotropin (HCG), the hormone that is elevated during pregnancy. Of note, there are two different types of pregnancy tests with differing accuracy.
- For tests that have a 90 percent accuracy: patients may test on the first day after their missed period.
- For tests that have a 97 percent accuracy: patients may test seven days after a missed period.
There are some instances where a false positive may occur, including after an abortion, miscarriage, or birth in the last eight weeks. The most common false negative occurs when the test is done too soon, so a negative test should be followed up with a repeat test a week later. Birth control does not affect test results.
Other common hormone tests include fertility and menopause tests, which also test the urine. Fertility tests detect Luteal Hormone (LH) to assist women in identifying the LH surge, predicting ovulation in the next 24-48 hours. False positives with this test may occur in those taking fertility medications, clomiphene within the past two days, recently pregnant, menopausal or those with poly cystic ovary syndrome (PCOS). Follicle stimulating hormone (FSH) urine tests are used to identify the onset of menopause. These tests must be confirmed with a health care provider, as false positives may occur during perimenopause, or the transitional stage. False negatives may occur if the urine is too diluted, so it’s recommended to use this test with the first urination of the day, and avoid large quantities of water before bed.
Other Urine Tests
Other urine tests include urinary tract infection tests and recreational drug tests. UTI tests assess for the presence of leukocyte esterase and/or nitrites. Leukocyte esterase is an enzyme present in white blood cells, indicating the presence of an infection. Nitrates indicate the presence of a specific type of bacteria, such as E. Coli, that process nitrates from our diet to nitrites in our urine. UTI tests can be helpful for women to identify when it is necessary to see a health care provider for additional care such as accessing antibiotics. Those who are vegetarian should be aware that they are at high risk of a false negative because their diets are low in nitrates, which are needed for the bacteria to make nitrites. Other causes of false negatives include use of an antibiotic called tetracycline, and use of Vitamin C in quantities greater than 250mg. False positives may occur with the use of a common urinary pain reliever, phenazopyridine (AZO), prior to testing as it stains the urine an orange/red color.
At-home drug testing is often utilized to identify recreational drug use. It may be used by those who worry about facing stigma by health care providers or employers, or by parents who wish to identify if their children are using recreational drugs, among other reasons. There are a multitude of different drugs tested and tests can be bought as a multi-drug test or a single drug test. Drug tests are available to test the urine, saliva, hair and blood. These different routes detect different durations of drug use. Saliva, blood and urine tests detect drugs up to one week from use, while hair tests can detect use up to three months after and are required to be shipped out to a lab. Many over the counter supplements and medications may cause false positives, including dextromethorphan (Robitussin), codeine-containing cough syrup, decongestants such as pseudoephedrine (Sudafed), antidiarrheals such as loperamide (Imodium), and high quantities of poppy seeds in your diet.
Laboratory or Send-Out Testing
Many at-home tests require at-home collection and then are sent out to a laboratory for anonymous testing. This is done for a variety of different purposes, including genetic tests, male fertility testing, HIV or hepatitis testing, and even for cholesterol testing. People may prefer this method to avoid unnecessary interaction with the health care system or so they can cope with stigmatizing results within their own home.
Male fertility testing is commonly done in the office with reproductive healthcare providers but simple at-home tests may be the first step in identifying a need for specialized care. At-home male fertility testing tests sperm concentration, but not the quality of the sperm, so it is not foolproof. It must be repeated at least three days after but no more than seven days after the first test.
HIV and hepatitis testing requires a blood result that is sent into the laboratory for testing, although new HIV tests using saliva can be done completely at home. Positive results should always be confirmed by a healthcare provider. Of note, it can take up to six months for HIV antibodies to be developed, therefore the test should be repeated six months after exposure.
At-home cholesterol testing also uses a send-out blood sample. These results should not be used to self-adjust cholesterol medication. Consuming greater than 500 mg of Vitamin C within 4 hours of the test can interfere with the result.
Fecal Occult Blood Testing
Another common send-out test includes at home tests for colon cancer, often referred to as fecal occult blood testing. A stool sample is collected and sent to the laboratory for testing, although an in-toilet test has been developed as a completely at-home alternative. The test is three steps and is meant to be repeated on three consecutive bowel movements. A test tissue is placed into the toilet prior to using the restroom to detect blood in the stool, and a positive result is indicated by a color change. Any positive result should be confirmed by a health care provider as there are many other reasons blood can be present in the stool, including irritable bowel disease, ulcers, hemorrhoids, colitis, diverticulitis, and fissures. Patients should avoid aspirin, NSAIDs such as ibuprofen (Advil) and naproxen (Aleve), steroids, rectal ointments, and Vitamin C in quantities greater than 250mg/day when using these tests.
The at-home tests mentioned above are just a fraction of the available products on the market. No matter the test, those using these products should be encouraged to research the accuracy of said test and offered counseling points to assure effective and successful at home use. Home tests are a useful tool for people to get involved in their care and become knowledgeable about their health, but come with specific limitations that should be outlined prior to use.
For more tips on living well, visit the Be Well blog.
Find a Doctor
