Expert guide to home health tests: Great idea or pandering to the ‘worried well’?
Australians can now do at-home tests for everything from menopause to sexually transmitted diseases. But which DIY kits can you rely on?
Walk down the aisle of any chemist and you’ll come across a growing list of home self-testing kits. Vitamin D deficiency, perimenopause, urinary tract infections, STIs are among the conditions to be tested. Go online and there are even more – including at-home cholesterol and blood-glucose testing.
As we all strive to understand our health better, information is key, but context is critical.
The Covid pandemic normalised home testing. But like Covid, the results of point-in-time home tests may not be as black and white as they seem.
Mark Morgan, chair of the Royal Australian College of General Practitioners expert committee on quality care, says the fallibility of Covid tests, which can depend on many factors such as how sensitive the test is and when it is taken, can apply in situations beyond the pandemic.
“Pregnancy self-testing kits have been around for decades,” Professor Morgan says. “A positive test is life-changing, but a negative test might miss very early pregnancy.”
Home testing is generally carried out through either pinprick blood tests or urine testing. Professor Morgan says at a helicopter level, this self-testing has its place, with significant caveats.
“Home testing certainly kicks goals for convenience. For some tests such as sexually transmitted diseases, home tests also afford some additional privacy. On the flip side, results of tests can be confusing, inaccurate and misleading.
“Imagine doing a self-test that turns out to be falsely reassuring. For example, using a phone app to look at a new dark spot on your skin. If the phone app provides false reassurance it might delay your diagnosis of skin cancer,” he says.
“Buying a self-test to engage in some sort of hunt for conditions may well do you more harm than benefit. An example might be self-testing for food allergies that might then lead to a lifetime of restricted diet with no appreciable benefits to health.
“One helpful rule of thumb before doing any test – ‘will the result change what I do next?’
“There are thousands of blood tests available, but doctors will be highly selective about which ones to recommend because some tests just don’t matter,” Professor Morgan says.
But John Kelly, chief executive of Atomo Diagnostics, a listed company providing HIV self-testing kits and developing a syphilis home-test, says Australia has been “relatively slow to adopt widespread rapid testing, due in large part to the reimbursement for testing being heavily skewed to laboratory testing services”.
“This can adversely impact how testing is offered to the community, and we saw this with an over-reliance on PCR testing during the Covid pandemic,” Mr Kelly says.
“There are certainly participants in the healthcare industry that will lose market share as the transition to decentralised point-of-care testing and self-testing accelerates.”
In an effort to provide some clarity for consumers, we’ve had medical experts take a look at some of the raft of home-tests now available.
Cholesterol home screening
Product: Lifesmart Cholesterol Multifunctional Monitor – cholesterol, blood glucose, ketone. $69 plus shipping (Online from ablehealth.com.au). Cholesterol test strips sold separately. $39.95 for 10.
The test requires a small pin prick to obtain a blood droplet, which is placed on the test strip. That strip is put into the monitor for analysis.
It connects to a smartphone via Bluetooth, so that all information can be viewed and analysed in real time. You are also provided with a guide as to what is considered desirable, borderline high, or high, with advice on what to do next, including contacting your GP if it is high.
A free app will allow you to share the data with your doctor, dietitian or family. A similar product in the UK allows a patient to send the results directly to the NHS.
Paul Glasziou, emeritus professor of evidence-based practice at Bond University, says cholesterol is just one element to consider when assessing someone’s risk of heart disease, so an overemphasis on it can be risky.
“Further, even with a good lab analysing a good blood sample there can be significant variation over different days, between 5 and 10 per cent, even if the person’s cholesterol is stable,” Professor Glasziou says.
“Clinically there is really only a need to test a person’s cholesterol every one to three years, for instance during someone’s annual health check.
“All the rest is just noise, a waste of money, and anxiety-inducing. The random variations mean a person is likely to over-interpret the results. I think it’s an appeal to the worried well,” he says.
STI self-screening
Product: TouchBio Chlamydia and Gonorrhea rapid test (for females) $24 (available online)
Product: Atomo Diagnostics HIV Self Test ($25 online or in selected pharmacies) (Syphilis test in development)
The first of these tests is conducted by collecting a vaginal swab, and using a process similar to a Covid RAT test to obtain a reading. It has some limitations, in that it may not detect some chlamydia strains contracted within 60 days of the test, and similar for gonorrhoea strains within 10 days.
The second test is done by a pin prick blood test.
The RACGP chair of specific interests, sexual health medicine, Sara Whitburn, says “better access to testing and subsequent treatment for positive results is crucial for reducing the transmission of STIs, so new initiatives to encourage testing are welcome”.
Mr Kelly says his company’s experience with HIV testing reveals many people will avoid going to the doctor when concerned about sexually transmitted infections.
“This is due to a broad range of factors including embarrassment, cultural barriers to seeking testing, familiarity – their doctor knows the partner or children.
“Some people don’t want an STI test registered on the Medicare record. A lot of immigrant arrivals are not in the healthcare system and don’t have a doctor,” he says.
Dr Whitburn warns the chlamydia and gonorrhoea test is limited.
“It is validated only for vaginal samples, so it can’t be used to screen for oral or anal chlamydia and gonorrhoea,” Dr Whitburn says.
“Chlamydia also often presents as asymptomatic, and gonorrhoea may by asymptomatic or symptoms may not present until months after infection.
“Improved access to screening is valuable, but regular testing with your GP or a sexual health professional who can test for these and other infections is still essential for sexually active people,” she says.
Bowel screening
Product: Colovantage Home Test ($45 online or in some chemists)
This is a faecal immunochemical test for the screening of bowel disease. It detects whether there are traces of blood in the stool as a result of colorectal disease. The method is somewhat complex, including collecting water around the stool in the toilet for analysis.
Australia already has a free national bowel screening program. Test kits are sent every two years to all Australians aged 50 and over. And since last year those aged 45-49 are eligible to screen with the program if they apply.
There has been some recent concern about younger people being diagnosed with colorectal cancers.
“Colorectal cancer was the fourth-leading cause of cancer death in both men and women younger than 50 years in the late-1990s but is now first in men and second in women,” the American Cancer Society wrote in its report Cancer Statistics 2024.
Professor Glasziou says the Australian government’s screening program is about right on a cost-benefit analysis.
“There has been some argument about the age at which the free screening starts, but I would say about 50 is the right age.
“The exception would be for those with a family history. I’d suggest they maintain regular contact with their GP on this,” he says.
Perimenopause
Product: WeTestBio Perimenopause FSH Home Test Kit ($29 for a two-pack online or at pharmacies)
The test is performed using a urine sample. The information coming with the test says that “as the female body ages and produces less oestrogen, FSH (follicle stimulating hormone) levels increase as the hormone tries to stimulate the ovaries to produce a healthy egg”.
“This test measures FSH and can determine if the body is producing FSH as a result of low oestrogen levels, signalling that the individual may be in the perimenopause stage.”
Dr Whitburn issues a caution on this test.
“As per Australian and international menopause guidelines, FSH is not used to diagnose or assess perimenopause and if it is required due to early or unusual symptoms then a blood test can be offered by a health professional,” she says.
“Perimenopause is a clinical diagnosis based on the onset of menopausal symptoms (some or all of symptoms such as irregular periods, hot flushes, night sweats or sleep disturbance) to 12 months after the last menstrual period.
“A symptoms score sheet that can be taken to an appointment with a health professional is a more useful assessment of perimenopause,” Dr Whitburn says.
Thrush
Product: Canestan Vaginal ph, Self Test $17.39 (online and at pharmacies)
This test provides a rapid diagnosis for thrush or bacterial vaginosis, and claims greater than 90 per cent accuracy.
It is undertaken by a vaginal swab done at home.
Again Dr Whitburn raises the issue of whether a patient will receive all the information they need from a home test such as this.
“Testing for pH is only one part of the diagnosis of vaginal discharge. Testing pH could miss other causes of vaginal discharge such as sexually transmitted infections or other genital or cervical conditions.
“Your health professional can take a history, provide a sensitive physical examination testing including swabs specifically for thrush and bacterial vaginosis, can assist with diagnosis and then can discuss with you about the most appropriate management for the cause of vaginal symptoms.”
Urinary Tract Infections
Product: WeTestBio – Multihealth home test kits: UTI, dehydration, PH, vitamin C. $29 (three tests)
This test is done using a urine sample. It notes that around 50 per cent of women will get a UTI in their lifetime.
Professor Glasziou sees some place for UTI home testing.
“You don’t want to be doing tests like this if you are asymptomatic, but if you’ve had a UTI and you may be experiencing recurring symptoms, it can be useful. If the test is positive then go and see your doctor.”
Vitamin D and Iron
Product: WeTestBio vitamin D home test – Iron home test, each $19 (1 pack) blood test
The tests are done using a pin prick of blood from the finger. WeTestBio notes that more than one in three Australians have vitamin D levels regarded as medically deficient, and up to 2 million Australians reportedly have some form of medically diagnosed iron deficiency or anaemia.
Professor Glasziou says that in general he is “a vitamin D testing sceptic”.
“Being outdoors for 15 minutes a day in Australia would be enough. Yes there are some people who are low in vitamin D and for them it’s worth supplementing.
“And like with iron, if I was feeling low in energy for some reason, I think that is enough to warrant a visit to my GP to get a more comprehensive understanding of what might be going on. Vitamin D and iron/anaemia are just two of numerous causes of fatigue.”
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