Why I Don’t Suggest Direct-to-Consumer Labs

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There are a number of lab companies now offering direct-to-consumer (DTC) labs. These include conventional and alternative labs. At first blush, this may seem like a good idea – for just the cost of the lab, you can access data about your health. However, there are some aspects of this trend that you should know before you start ordering your own labs. 

First and foremost, think about how you will use the information you get from those labs. Do you know what they mean? What treatment should you do with various results? And what kind of follow-up is recommended to ensure you are on the right track? While it’s tempting to turn to Doctor Google or AI, lab results do not always correlate one to one with a suggested treatment. You may lose both individualization and the big picture when relying on these for health advice.  

Some of the DTC labs include testing that really is not that actionable. One of my patients provided me with results that had several pages of data about the bacteria types found in her stool. While information about some microbes in the stool, particularly those that cause disease, may be very useful, these results included a list of hundreds of bacteria that was essentially useless. Other companies don’t provide raw data, but simply summary conclusions and, often, supplement recommendations based on a limited data set and no individual consultation. 

I’ve had other patients bring me results from DTC labs when they were concerned about the results. When I have reached out to these types of labs, they have not responded to me. If they only provide conclusions, I can’t see the data those conclusions are based on. I’m also unable to verify testing methods, determine testing methodology or request a consultation. Because of these factors, other physicians have told me they won’t even look at DTC labs. When physicians order labs from professional partner labs, if the results are atypical, the lab will sometimes repeat the lab at no cost to the patient to ensure there was no lab error and will always consult on the results. 

And finally, there is the issue of cost. Getting labs done without a doctor’s visit may seem like a cost savings, but sometimes, the same or similar test may cost less through a doctor’s office. A quick review of DTC lab pricing for simple thyroid tests showed that one lab charges $54 for a TSH test, whereas the lab I use for cash-paying patients would charge $23 for the same test or $33 for a complete thyroid panel. I’ve seen similar differences in favor of in-office ordering for other testing. 

While this new trend does put consumers in the driver’s seat of their health care, it’s important to consider these factors in deciding if ordering your own labs will have value for you. 

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