What You Should Know About At-Home Thyroid Test Kits

With Steven D. Shapiro MD

Why people are turning to at-home thyroid tests, what they can tell you, and what you should know before purchasing one

Thyroid gland made of flowers

Your thyroid gland is small but mighty. Shaped like a small butterfly at the base of your neck, it releases two all-important hormones: thyroxine (T4) and triiodothyronine (T3).

Both T3 and T4 are circulated through your bloodstream and are responsible for everything from metabolism and bone health to sleep, mood, and libido.

Think of your thyroid gland as part of a master control center working with both the pituitary gland (found at the bottom base of your skull) and the hypothalamus (which is located in your brain). 

Before T3 or T4 can be used, your hypothalamus releases a chemical called thyrotropin-releasing hormone. It is this first-step hormone that triggers your pituitary gland to then release something called thyroid stimulating hormone (TSH). The TSH then kicks your thyroid gland into gear.

Ideally, when your T3 and T4 levels are low, your pituitary gland releases additional TSH. When these hormones are too high, your gland will release less TSH. This is an oversimplification of a very complex process, but the whole system can be thrown off by a number of variables, including stress, genetics, your environment or food, which is why testing your thyroid health is so necessary if you suspect anything may be amiss.

When your hormone levels are too high or too low, conditions may include

Common symptoms that could indicate a thyroid issue include

  • Brain fog, trouble concentration, or memory issues
  • Unexplained weight gain or loss
  • Fatigue
  • Depression or other mood issues
  • Nervousness or lethargy
  • Dry skin and hair
  • Always feeling cold or overheated
  • Constipation
  • Slow heart rate or rapid heart rate
  • Period changes
  • Brittle hair, skin and nails
  • Excessive sweating

How do at-home thyroid tests work?

According to Steven D. Shapiro MD, at-home thyroid tests are very easy to use. “They are sent directly to your house, require an easy finger prick, and are sent back in the mail. Most kit providers can turn results around within just a few days, similar to the wait-time for in-person lab results.”

When the kit comes, you’ll clean your finger with disinfectant and then prick it with a small lancet in order to collect blood. You’ll then drop approximately five small drops of blood onto a test strip or into a small tube. Next, you’ll pop it into a provided package to be sent back to the lab. The kit comes with everything you need. After you send the test strip out, the lab will then send results directly to you, usually through an electronic portal that you will sign up for when buying the kit.

What about direct-to-consumer thyroid tests?

It’s important to note that there’s another kind of thyroid test available that allows you to bypass your doctor’s office. This is called a direct-to-consumer (DTC) thyroid test and includes working with a DTC provider. People who are interested in this option may also be interested in an at-home test kit, and vice versa.

If you go this route you will order a thyroid test through the provider itself. The provider will then give you a lab request slip, which you will bring to a local laboratory for blood work, meaning blood will be drawn through your vein, rather than with a fingertip lancet.

The labs used usually include LabCorp or Quest, which are likely the same that your doctor uses. The process and results are similar to getting your blood drawn by your doctor. The only difference is that the results go to you, and you order your own blood work.

What can at-home thyroid tests tell you?

At-home thyroid tests aim to test your hormone levels and antibodies. Depending on the kit and its provider, what they test for varies. Below are some of biomarkers that various kits are able to test for.

  • Thyroid stimulating hormone (TSH)
  • Free triiodothyronine (free T3)
  • Free thyroxine (free T4)
  • Thyroglobulin antibodies (TgAb)
  • Thyroid antibodies (TPO/TPEX)

These tests can be helpful if you’re seeking a fuller picture of your thyroid health, as some medical providers only test for TSH, rather than, say, free T3 or T4 or antibodies.

The most popular at-home thyroid test kits include

  • Everlywell’s CLIA-certified Thyroid Test. It tests your TSH, free T3, free T4, and thyroid peroxidase antibodies.
  • Paloma Health’s CLIA-certified Complete Thyroid Blood Test. This tests for TSH, free T3, free T4, and thyroid peroxidase antibodies, with an option to add on vitamin D3 and reverse T3.
  • Let’sGetChecked’s CLIA-certified Thyroid and Thyroid Antibodies Tests check for TSH, free T3 and free T4 as well as thyroglobulin antibodies and thyroid peroxidase antibodies.

How to understand the results of your thyroid test

“Many at-home test kits provide some level of interpretation within their test results which is usually emailed or found within their online patient portal,” says Dr. Shapiro. “However, it is still important to pass results on to your physician in order to arrive at a true diagnosis and begin treatment."

Getting your hormone levels back on track if your test results and physician confirm a thyroid issue is a complex medical process, which is why working with an endocrinologist or other health professional who understands your thyroid is so vital if you do get a result outside of the typical range.

Why would someone use an at-home thyroid test kit?

First, the kits might be an easy way to get a first glance at your thyroid health, especially if you have a sneaking suspicion that something could be off.

“The kits are a great option for anyone looking to get more information on their thyroid function. They can be ordered by the consumer rather than having to go to a doctor to send your lab requisition,” says endocrinolgist Sapna Shah MD of Paloma Health.

“People experience all types of side effects from poor thyroid health, and starting with a thyroid screening can help to narrow things down and get to the root of the issue,” Dr. Shapiro adds. On the flip side, they’re also for people who might already have a diagnosed condition and require regular lab results, he also notes.

“When getting to a lab is difficult (due to distance or physical condition) at-home tests can be a nice way to access care and information,” says Dr. Shah.

And then there’s the aspect of social distancing and safety: “People are leaning towards at-home treatments now more than ever because of COVID,” Dr. Shapiro says. “Staying out of busy waiting rooms is a good enough reason alone.”

At-home thyroid tests can also help cut down on costs and co-pays, as the test itself can be bought for a single fee. For example, the Everlywell kit tests for three main thyroid hormones: TSH, T3, and T4, as well as thyroid antibodies. It costs $99, which could be less than a doctor’s visit, copay, lab costs, or any potential out-of-network fees, depending on your health coverage.

Some test kits can also be paid for with your Flexible Spending Account (FSA) or Health Savings Account (HSA). 

Although there are benefits to using an at-home test kit, you will still need to see a doctor for help interpreting the results and getting treatment if your results are atypical. Even though the margin for error low, accidents do happen. You should never increase, decrease, or change your medicine without checking with your doctor first.

Comparing at-home test kits to thyroid tests administered by your doctor

There are a few key differences between taking an at-home test and setting up a doctor’s appointment.

“The main difference is that at-home tests are done either on a dry blood collection card or tube requiring about five drops of blood, versus in a doctor's office or a traditional lab where they take vials of blood from your vein,” according to Dr. Shah.

“The lab takes three to five days to process at-home test samples and a doctor's office or lab may turn results around in one to two days.”

A few things to watch out for: “Mostly everything else is the same about the tests, with the exception that reference ranges and units of measure can sometimes be different, specifically with ‘unstandardized’ tests like TPO antibodies — so if you want to track levels over time, it's important to use the same lab to do so,” Dr. Shah adds.

Let’s explore further: Typically, TPO antibodies are measured in international units per milliliter (IU/mL), and anything under 9.0 IU/mL is considered normal. Different labs may measure TPO with a different unit of measurement or may even have a different standard range.

For this reason, it’s important to keep note of the units of measurement as well as the results and ranges, especially if you’re using different test kits OR laboratories for results analysis.

How do you know if a thyroid test kit is reputable?

First, it’s important that the test kit itself is certified by Clinical Laboratory Improvement Amendments (CLIA), which ensures quality laboratory testing. You’ll also want to check if they are certified by the College of American Pathologists (CAP), which ensures best practices regarding obtaining accuracy of test results and meeting other important required standards. 

According to Dr. Shah, “The lab Paloma Health uses is a CLIA and CAP-certified lab, government-certified at the gold standard of the lab industry. The labs are tested versus commercially available labs to be equivalent in their results.”

The same goes for other test kits made by other companies: “Other services who use CLIA- and CAP-certified labs will also provide accurate readings,” she says.

Dr. Shapiro also recommends asking your endocrinologist or healthcare provider if they can recommend a reputable thyroid test kit.

The good news is that at-home test kits, when bought by a reputable provider, are generally very reliable. According to a study in the Journal of Medical Screening, they offer “accurate and inexpensive testing.”

Thyroid Test Kit Fast Facts

  • At-home thyroid test kits are considered very accurate, but you should make sure you are purchasing a CLIA- and CAP-certified test through a reputable provider.
  • Popular thyroid kits offer testing for several biomarkers, including free thyroxine (Free T4), free triiodothyronine (Free T3), thyroid stimulating hormone (TSH), and thyroid peroxidase antibodies (TPO), in addition to others.
  • At-home test kits are an inexpensive and easy way to learn more about your thyroid health or monitor your thyroid health without going to see a doctor for regular testing.
  • Most test kits will provide your test results along with a basic analysis of results, but it’s important to see your healthcare provider for in-depth analysis, diagnosis, and proper treatment.
  • You should never self-medicate or change a prescription or medical plan based off of at-home test kit results without speaking with your doctor first.
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