Which Cholesterol Tests Are Most Accurate?

Home cholesterol kits are handy, but are they accurate?

Cholesterol home test
Cholesterol home test. Getty Images/STEVE HORRELL/SPL

You may be tempted to use a home cholesterol testing kit, but are these kits accurate? If you have high cholesterol, home testing seems convenient and can be less expensive than a lab bill. But these tests are limited in the information they provide. Experts say home tests cannot replace regular cholesterol testing at your doctor’s office.

Types of Home Cholesterol Tests

There are three basic types of home cholesterol tests that can be purchased online or at your local pharmacy:

  • Kits with test strips you read visually. You add a drop of blood from a finger prick and read the color change after several minutes.
  • The second type requires purchasing a small analyzer, much like a glucose meter, and costs more. You do a fingerstick, but enter the strip into the analyzer, and it reads it. This is less prone to errors you might make in reading a color change yourself.
  • The third type of test requires you to send blood samples to a laboratory. You have to wait for them to return your results, but the analysis is done by professionals.

The FDA has approved home cholesterol tests that measure total cholesterol, high-density lipoprotein (HDL), and triglycerides. There is one that measures LDL. You need to check the packaging to see which of these your kit tests.

Typically, tests conducted in a laboratory or through your doctor’s office will provide more comprehensive results, often including low-density lipoprotein (LDL) levels and triglycerides.

These are important when determining your overall cardiovascular risk, and they are something many people want to lower. If you opt for home testing, it is best to use the most comprehensive meter or kit to get these values.

Is Home Testing Recommended?

The American Heart Association hasn't taken a stance on at-home cholesterol testing except to say that the test should not be used in place of testing at your doctor’s office.

It’s best to talk to your doctor about the benefits and pitfalls of home cholesterol testing before purchasing any home testing kits.

At-home tests do not provide enough information to assess your cardiovascular risk or decide whether or not treatment may be necessary. Regular cholesterol testing through your physician's office is necessary for both risk assessment and treatment decisions.

How Good Are You at Following Directions?

If you have trouble following a complicated recipe or putting together a piece of IKEA furniture, home lab testing is probably not a good idea for you. The biggest problem with home testing is whether you can follow the directions included. Just because you are able to get some kind of reading doesn't mean you did it right and the reading is accurate. Here are things that can go wrong:

  • Was fasting required and did you comply?
  • Did you get a good drop of blood on the strip?
  • Did you read it at the right time?
  • Did you make sure the test kit was properly stored and none of the strips were past their expiration dates?
  • For the color change test, have you been tested for color blindness? Laboratory personnel are tested for this, and many didn't know they were before the test.
  • Do you find the instructions hard to understand and follow?

These are all sources of error. If you aren't used to following instructions precisely and performing medical laboratory testing, home testing will likely be less accurate. If you get inconsistent results, they should be checked by your doctor with a lab test.

Accuracy of Home Cholesterol Tests

The FDA says the at-home tests they have approved are about as accurate as the tests done by your doctor, if you follow the instructions correctly. The at-home tests have accuracy data included in the packaging information. You can also search the FDA database to determine whether or not an over-the-counter test has been approved.

Outside of research conducted by the companies themselves, there is little data regarding the accuracy of at-home cholesterol tests. According to a 2004 meta-analysis published in The Annals of Pharmacotherapy, study authors wrote, "We can expect them [these at-home tests] to accurately classify 80 to 90% of patients” into the correct cardiovascular risk category. These categories can range from low to very high.

If you are using a test that requires a blood sample to be shipped to a laboratory, make sure the laboratory has been certified by the CDC's Cholesterol Reference Method Laboratory Network. If that information isn’t included in the product packaging information, don’t hesitate to contact the manufacturer. The CDC also maintains a list of certified laboratories.

Purchasing Tests

Tests will vary widely in terms of cost. Just make sure the test measures the cholesterol levels you are interested in and search the database to make sure that the test is FDA-approved.

If you are purchasing a cholesterol test at a pharmacy, don’t hesitate to ask the pharmacist about the test. If you are buying a cholesterol test or any other medical product online, the FDA recommends taking a few precautionary measures:

  • Read the labels: If the label and other packaging information are written in multiple languages, the product is likely made outside the United States. This could mean the FDA has not approved the test. Look for U.S. addresses and phone numbers.
  • Talk to your doctor: Before spending money online, talk to a physician or another healthcare provider about the product.
  • Ask questions: If you have questions, call or e-mail the seller or manufacturer and ask if the FDA has approved the product.

Be sure to follow the at-home test directions closely, keeping in mind that slight deviations from the instructions could affect your results.

Sources:

"Buying Medicines and Medical Products Online." FDA.gov. 2008. Food and Drug Administration. 28 Aug. 2008

"Cholesterol, Home Testing Devices." AmericanHeart.org. 2008. American Heart Association. 28 Aug. 2008

"Cholesterol Reference Method Laboratory Network." CDC.gov. 11 Sep. 2007. Centers for Disease Control. 28 Aug. 2008

"Home-Use Tests -- Cholesterol." FDA.gov. Food and Drug Administration. 06/052014

Taylor, J. and L. Lopez. "Cholesterol: Point of Care Testing." The Annals of Pharmacotherapy. 38(2004): 1252-7. <http://www.theannals.com/cgi/content/abstract/38/7/1252> (subscription).

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