Lana McDonald, a 34-year-old teacher from Massachusetts, got an Oura Ring two years ago to track her sleep. When she got an email from Oura selling a set of blood tests for $99, she was intrigued. Her primary care physician had never ordered blood testing before.
The app took her to the website for Quest Diagnostics, where she got an appointment within the week. The results started coming in that same day.
Direct-to-consumer blood testing is a growing industry targeting health-conscious patients who want to order their own blood work for the price of a dinner out.
The space is becoming increasingly crowded: both by direct offerings from commercial laboratories such as Quest and Labcorp OnDemand, and by companies that partner with them to offer the testing. Recent blood-testing rollouts came from Oura, which has sold some 5.5 million of its smart rings and is aiming at that customer base, and from the wearable company Whoop.
The telehealth platform Hims & Hers, with 2.5 million members, also released a product in late 2025. Meanwhile, the health care technology company Function Health, which offers testing to its hundreds of thousands of members, received a $2.5 billion valuation after a recent funding round.
This growing trend disrupts a long-standing paradigm in which your doctor tells you when you need a test, calls you with the results and offers a treatment plan. Instead, consumers like McDonald are taking the initiative to order tests and are left to interpret the results on their own.
"There's this idea that more information is better — that having access to information is empowerment," says Dr. Anna Wexler, an assistant professor of Medical Ethics and Health Policy at the University of Pennsylvania. "That's kind of appealing to maybe more of the longevity, biohacker, someone who's interested in all their metrics."
But it also can leave patients to reckon with stressful information they don't know what to make of — and receive either a worrying result that may or may not require action, or a false reassurance of a clean bill of health.
What do the tests mean?
For McDonald, eight of her results were out of range, including "high" cholesterol levels and "low" hemoglobin. The results didn't come with any explanation. Puzzled, McDonald turned to Google to figure out what to make of them and what follow-up testing she might need. She decided to order a ferritin test, a measure of iron storage protein, directly from Quest. It was low.
McDonald's next steps were trickier. She downloaded the results from Quest's website and direct-messaged her own physician the results through a portal, who told her to set up an appointment. Then she waited two months until her doctor could see her.
As in McDonald's case, most patients will never hear from the clinicians contracted by the testing company who interpreted their results. Without the context of an ongoing patient-provider relationship, it's hard to contextualize lab values that are abnormal — or decide what to do next.
"Patients are getting outside testing done and bringing them to appointments asking us to interpret them for them," Dr. Jeffrey Linder, chief of general internal medicine at Northwestern University's Feinberg School of Medicine, said in an email.
Both Oura and Function Health use third-party clinician partners to interpret the tests and call patients with a critical result.
"It's essential for people to have an ongoing relationship with a health care provider," Dr. Ricky Bloomfield, chief medical officer at Oura, said in an email. Their blood test product is intended "to complement — not replace — that relationship."
But some see the use of physician partners as problematic.
"The company that you actually order the test from may contract with the physician group, and so they'll say, 'We're just a platform that's connecting you to the physician. We're not responsible,'" says Wexler. "There's real questions of liability and accountability in this direct-to-consumer space."
To help explain labs and track health over time, Function rolled out an integration with OpenAI's ChatGPT Health. A press release from OpenAI emphasized that ChatGPT health is not designed to replace medical care.
Given the ambiguity of interpreting results, Linder says this model may raise unnecessary fears.
"There's this unrealistic expectation that the only two outcomes are you're going to get a clean bill of health or you're going to find something that's going to kill you," said Linder. "It's so much more likely that you're going to find something indeterminate that's going to cause anxiety and that is actually not going to improve your health."
Appealing to the DIY patient
These tests offer patients something that the health care system struggles to provide: transparency in price.
Function Health offers a membership that includes twice-yearly blood testing and costs $365, with more than 160 biomarkers tested annually. According to Function Health, 40% of Function's members come from ZIP codes with median household incomes less than $95,000.
Hims & Hers offers twice-yearly testing for $499 a year, currently discounted to $349, with more than 130 biomarkers tested annually. Another direct-to-consumer company called Superpower advertises over 100 tests for $199.
"I think it comes completely as a response to frustration with the current state of our health care system: the lack of transparency in terms of cost, the difficulty of scheduling with a physician," says Wexler. "These tests: they provide convenience, they provide transparency in costs."
Many of these companies also offer access to tests that are not used commonly in general clinical practice.
Function Health, for example, offers additional add-on testing, including an extensive panel of brain health tests.
Dr. Mark Hyman, the co-founder and chief medical officer of Function Health, says he thinks this kind of testing is valuable because it can catch early signs of disease.
"The more you understand earlier on in your trajectory of health, you can create predictive models of where you are headed. That's the future of medicine. It's highly predictive: early diagnostics, ongoing tracking to see where you're at, and the longitudinal data," says Hyman.
Hyman is one of the most vocal proponents of functional medicine, an alternative approach to medicine that emphasizes lifestyle changes and supplements along with more mainstream treatments.
Oura offers less extensive testing.
"We've been intentional about starting with a small set of evidence-based labs rather than a large set of scattershot tests for which there is little evidence of benefit in the general population," Bloomfield said in an email.
Blood work overkill?
Advertising from these companies may drive patients to seek regular, frequent blood work, which concerns Linder of Northwestern University. Several companies test twice yearly as part of their membership offering. Oura has not recommended a specific testing schedule, but Bloomfield says they "anticipate most members will test once per year to establish a baseline."
Annual or even more frequent testing is not the standard of care, says Linder.
Whether or not you need blood work is a decision best answered in consultation with your doctor, he argues.
Linder cautions his patients against normalizing frequent blood testing.
"Everybody comes in and they're like, 'I want my routine blood work' — and that's not a thing," says Linder. He finds "the American idea" that you need annual blood tests baffling.
He recommends much less frequent testing for healthy people — in line with the recommendations from the U.S. Preventive Services Task Force, the CDC, the American Heart Association and the American College of Cardiology.
He generally follows recommendations to screen patients every five years for cholesterol, and one time for HIV and hepatitis C.
He notes that people with risk factors for Type 2 diabetes may need more testing. The USPSTF recommends checking an A1c in people who are overweight or obese starting at age 35.
Seeking more information more frequently can also bring an additional risk: one of which is what Linder calls a "medical misadventure," a cascade of further testing following up on an abnormal result.
One example is the complete blood count, or CBC, a component of many direct-to-consumer blood tests. The CBC measures components of the blood, such as red and white blood cells. The normal ranges for blood counts are scaled on a healthy population.
"As we get older, like, you kind of just fall out of the normal range, and it's not actually a manifestation of poor health," says Linder. "You can even imagine a cascade where this leads to a bone marrow biopsy, something invasive and painful that has just a vanishingly small probability of turning up anything that is actually going to wind up improving your health."
A study aimed at understanding the role of cascades in medical care found that in 33% of cases, the initial test that led to the cascade was clinically inappropriate.
A winding journey
For McDonald, it took a few months to follow up on the testing she got through Oura. After she sent her doctor the results, he asked to repeat the testing through his own lab. This time it was free to her since it was covered by her insurance. The testing, which was also at a Quest lab, showed very similar results.
Her doctor diagnosed McDonald with anemia, though she wasn't experiencing symptoms, and started her on iron pills. She says he wasn't concerned about her cholesterol levels, but suggested lifestyle interventions all the same. They plan to repeat testing in two months.
Though she had a positive experience with Oura's testing, McDonald says she would not recommend the test to others:
"I figured I would just try it out, but I don't think it's worth it if you can order the same test for free if you have health insurance."
Kate Cunningham is a writer and an M.D.-Ph.D. student at Columbia University.
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