For the longest time, I was overcome with fatigue, insomnia, stress, and depression (with bouts of anxiety). I’ve seen many professionals about it: two MDs, a psychiatrist, therapist, functional-medicine doctor, naturopath, and even a hypnotherapist. As I expected, they advised me to improve my diet and exercise regimen in various ways (the naturopath also “prescribed” me nature walks and meditation), but I was still sluggish—even after I became the epitome of wellness. All my lab tests came back perfectly normal, so there was no cause for alarm either.
If you’ve ever experienced it, lethargy and depression are confusing. Do I still need to exercise more? Are there insufficient B vitamins in my diet? Does the infamous “3pm crash” simply intensify when you get older? Gasp—am I just lazy and unmotivated?
Without a clear diagnosis and lots of frustration, I looked into how I could capture my own health data. I discovered a company called EverlyWell, a company that offers a suite of regulatory-compliant, physician-reviewed, at-home lab tests. Depending on which test you choose, you send back a blood, urine, or saliva sample. And there are quite a few tests, including Food Sensitivity, Thyroid, Metabolism, Women’s Health and Fertility, Vitamin D, and Heavy Metals.
I was excited when I saw the Sleep and Stress test. Curious, I read through the details, where it listed the “common symptoms of elevated stress and sleep deprivation:
- Can't get to sleep or stay asleep
- Frequent or early waking
- Morning or evening fatigue
- Feeling 'tired but wired'
- High stress
- Irritability / impaired performance
- Hunger / sugar cravings
- Weight gain
Whoa. Aside from the weight gain, this described me to a tee. Sure, I already knew I was stressed and sleep-deprived, but I wanted to see the hard evidence. EverlyWell was kind enough to send me a kit to try.
How to Identify a Trustworthy At-Home Lab Testing Company
Before I ventured into self-testing, I first asked Marra Francis, MD, EverlyWell’s medical director, “How do you make sure a lab is credible and accurate?”
It’s simple. If you’re ever going to order an at-home lab test for yourself, look for these two acronyms: CLIA and CAP. “There are two certifications all labs use to certify how they’re running their tests and hold themselves to high standards: CLIA (Clinical Laboratory Improvement Amendments) and CAP (College of American Pathologists). What this means is not only are they adhering to all of the Occupational Safety and Health Administration’s standards and regulations that are put in place for the health, safety, and wellness of people working at the lab, they are also doing internal controls to make sure their labs are calibrated properly so the results are accurate and there is no cross-contamination between samples,” explains Dr. Francis.
And make sure you confirm both certifications. “Every lab has to have CLIA certification to maintain samples, but not every lab has to be CAP-accredited,” she cautions.
My Experience With the EverlyWell Test
EverlyWell sends you a box with all the supplies you need, including a biohazard Ziploc, step-by-step directions, and a pre-paid envelope so you can send your samples back.
For the Sleep and Stress test, I peed in a cup four times a day—upon waking up, before lunch, before dinner, and before bedtime. Each time, I wrote down the time and date on the collection card, dipped the card into the urine, then hung it on the towel rack to let dry overnight. The next day, I put all four cards into a biohazard bag and mailed it back. A week later, EverlyWell emailed me to let me know I can log into my account to check out the results.
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Every test comes with its own set of caveats and tips. But generally, when it comes to any of the tests, don’t eat, drink, or do anything differently than you normally would. Dr. Francis advises, “As far as preparation, it’s best that you don’t change anything because the tests are supposed to measure your day to day. So don’t drink extra water if you’re doing a urine test.” Makes sense.
My Shocking Results—and What Happened After
The best part about the test was the results. I have difficulty understanding traditional lab test results since they’re litanies of codes and unrecognizable medical terms. EverlyWell provides you with color-coded charts for each marker (the hormone or other substance they actually test for), along with a layman’s explanation of what the marker is and what your results may indicate.
I was simultaneously shocked and triumphant when I viewed my results: I had sky-high levels of cortisol (stress hormone) at night, high levels of cortisone (a metabolite of cortisol), high levels of melatonin (the sleep hormone) during the day, and low levels of melatonin at night.
My initial reaction? I’m not imagining my fatigue! I wasn’t crazy or lazy. I immediately made an appointment with my primary care physician, who was extremely receptive to the tests. (EverlyWell provides a doctor-friendly version of the results you can print out.) What happened next was beautiful.
Using the EverlyWell test results as a springboard, my doctor and I—for the first time ever—engaged in a more-than-thorough conversation about my health. We discussed in detail what the problem may be, and we navigated all the potential avenues that may be causing my abnormal hormone levels. He taught me that stress can cause hormone fluctuations, but it can also be the other way around. He also taught me that melatonin can be easily affected by other things, including estrogen.
In other words, handing him my results was a lot more helpful than my usual “I’m really, really tired and I don’t know why.”
After chatting, my doctor and I decided to test my estradiol (a type of estrogen), progesterone and luteinizing hormones—all of which are essential to a woman’s health. We learned that I was also low in these hormones. This makes sense, as low estradiol levels cause a lot of the same symptoms that led me to take the Sleep and Stress test in the first place. I’m now in the process of working with an endocrinologist—and we have a lot more information to start with.
The One Health Test Everyone Should Take
Choosing a test is straightforward if you have an active concern, but what if you feel just fine? Or a bit under the weather from time to time? According to Dr. Francis, everyone should test their heavy metal levels. “We’ve got so many things in our environment we’re exposed to on a daily basis that we don't even think about anymore. Doctors don’t ever screen for it unless you’re at the point where you’re being affected. That doesn’t necessarily mean heavy metals aren’t in your body; it just means you’re not sick enough yet,” she says. She adds that if you do learn that you have high levels of a toxin in your body, that gives you enough reason to test your children for the same thing—and that one decision can change your entire family’s health.
Some of us are lucky enough to partner with a diligent healthcare practitioner and uncover and tackle our problems right away. But in many cases, like mine, it’s difficult to pinpoint the issue since symptoms like fatigue and mood swings can mean so many things.
Another benefit of taking a health test yourself? You can potentially save a lot of money and bypass insurance red tape to discover your issues more quickly. Dr. Francis offers this example: Let’s say you experience a ton of bloating. Your doctor runs a celiac antibody test on you, but it comes back negative (meaning you don’t have celiac disease). It would be very difficult to have insurance pay for a full-on food sensitivity test. Instead, you’d end up at a specialist and pay for more tests. But what if all you needed was a food sensitivity test to begin with? Food sensitivity tests can be useful in the right context. Read our story, "Misunderstood? Setting the Record Straight on Food Sensitivity."
Obtaining my own health data was one of the most empowering actions I’ve taken for myself. Even my doctor was impressed I walked in as an informed patient. I may not have solved all my health woes yet simply by taking a home lab test, but I no longer feel stuck and hopeless. As Dr. Francis says, “We’re not necessarily giving you a diagnosis, but we’ll send you in the right direction.”
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