Specialty tests: what they add beyond a standard blood panel

Start with the question, then pick the test

A broad blood panel answers most first-round questions about metabolism, hormones, thyroid, iron and heart risk. Specialty tests make sense when something specific remains unexplained, such as how your body is processing hormones on therapy, how your blood sugar behaves after meals, or whether you want to add a multi-cancer screen to your usual screenings.

Many specialty tests are laboratory-developed tests, which are designed and run within a single lab. The FDA's 2024 rule to regulate these tests was vacated by a federal court in 2025, so most have not been cleared or approved by the FDA. Ask what each result could change before you order it.

DUTCH dried urine hormone test

The DUTCH test, $449 one-time, uses dried urine samples collected over a day to look at sex hormones, their breakdown products and the daily pattern of cortisol. It can show how estrogen is being metabolized and how cortisol rises and falls across the day, which a single blood draw cannot. It does not diagnose adrenal fatigue, which is not a recognized medical diagnosis, and it is not a substitute for formal testing for conditions such as Cushing's syndrome or Addison's disease.

If you use hormone therapy, especially creams, urine and blood results can disagree. Do not stop therapy before a test without your clinician's advice, and expect blood tests to remain the standard for many dosing decisions.

Gut microbiome and comprehensive stool panels

The Gut Biome Analysis, $625 one-time, profiles the bacteria in a stool sample and often reports a diversity score. The GI Effects plus Microbiomix panel, $1,095 one-time, adds markers related to digestion, inflammation and other gut functions. The microbiome shifts with diet, illness and medications, so a single sample is a snapshot. These tests cannot diagnose irritable bowel syndrome, inflammatory bowel disease or celiac disease, and they are not designed to detect small intestinal bacterial overgrowth. Red-flag symptoms such as blood in the stool, weight loss or anemia need standard medical evaluation.

Methylation and MTHFR

The Methylation Health Panel, $549 one-time, looks at homocysteine, folate and B12 status and can include common gene variants such as MTHFR. MTHFR variants are very common and, on their own, are not a diagnosis. Results from consumer DNA services were not designed for medical decisions. The practical value usually comes from the blood markers, which show whether your B vitamin status actually needs attention.

Galleri multi-cancer early detection

Galleri, $1,095 one-time, looks for a cancer signal in blood and predicts where in the body it may come from. In September 2026, an FDA advisory panel voted in favor of its benefit-risk profile for adults 50 and older, but as of this writing the FDA had not issued a final approval decision. Data presented to the panel showed it detects some cancers far better than others and that many positive results led to invasive follow-up tests.

Whether multi-cancer tests reduce deaths from cancer is still unknown; the National Cancer Institute's Vanguard Study was launched to help answer that question. A negative result does not rule out cancer, so keep up with mammograms, colon cancer screening and other recommended screenings.

Continuous glucose monitors

A continuous glucose monitor shows how your glucose responds to meals, exercise, sleep and stress across days, which an A1c or fasting glucose cannot. In 2024 the FDA cleared the first over-the-counter CGM for adults who do not use insulin, including people without diabetes. Without diabetes, a CGM is mainly an educational tool; one high reading after a meal is normal and not a cause for alarm. HealifyMD's CGM is $189 for one 14-day sensor, with a clinician visit included.

Semen analysis

The Male Fertility Test, $299 one-time, measures semen volume, sperm count, movement and shape. Abstaining from ejaculation for about 2 to 7 days beforehand, as your lab directs, helps accuracy, and an abnormal result is usually repeated because counts vary from sample to sample.