Integrative psychiatrists commonly draw on ordinary medical tests: thyroid function, vitamin B12 and folate, vitamin D, iron stores, blood sugar, cholesterol and sometimes a marker of inflammation. Some also discuss genetic testing or specialty panels. Which tests make sense depends on your symptoms, history and medications, and there is no standard integrative panel that everyone needs.
Part of our guide: A Guide to Integrative Psychiatry
One limit comes first. MedlinePlus, the National Library of Medicine's consumer health service, says there are no medical tests that can diagnose mental health disorders. Labs answer a narrower question: is something physical causing or adding to these symptoms, and is a medication safe to continue? The sections below sort common tests by how well they answer that question.
Tests that check for a medical cause
This is the best-established reason to order labs. The National Institute of Mental Health notes that certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression, and that a provider can rule these out with a physical exam, an interview and lab tests. MedlinePlus similarly says blood tests can show whether a condition such as thyroid disease or an electrolyte imbalance is behind mental health symptoms.
For thyroid problems, clinicians usually check TSH first, then add other tests if the result is abnormal. Our guide to thyroid problems that look like depression or anxiety goes through this in detail. It also explains why the U.S. Preventive Services Task Force's "insufficient evidence" position on screening applies to people without symptoms.
A quick guide to common tests
| Test | What it can tell you | What it cannot tell you |
|---|---|---|
| TSH and other thyroid tests | Whether the thyroid is underactive or overactive | Whether mood symptoms will lift once the thyroid is treated |
| Vitamin B12 and folate | Whether levels of these B vitamins are low | Whether a low level is the whole explanation for low mood |
| Vitamin D (25-hydroxy) | Whether you have enough vitamin D | Whether a supplement will help mood |
| Ferritin | How much iron your body has in reserve | A reliable reading during inflammation, which can raise it |
| A1C, fasting glucose and lipids | Average blood sugar and blood fats, including medication side effects | Whether metabolic health is driving a psychiatric symptom |
| C-reactive protein (CRP) | How much inflammation is in the body | What is causing the inflammation or where it is |
| Pharmacogenomic panels | Predicted gene and drug interactions for some medications | Which medication will work for you |
Nutrient tests: useful, and easy to over-read
MedlinePlus lists mood changes such as depression and anxiety among the possible signs of low B vitamins, along with memory problems, and says testing is used when symptoms or risk factors suggest a shortfall. Risk factors can include certain conditions, restricted diets and past digestive surgery. A true deficiency is worth finding and treating with a clinician's guidance.
Vitamin D is where the gap between testing and evidence is widest. MedlinePlus states that routine vitamin D testing is not recommended for everyone, and the Task Force found the evidence insufficient to assess the balance of benefits and harms of screening adults without symptoms. A large trial of 18,353 adults aged 50 or older without clinically relevant depressive symptoms at the start found that vitamin D3 did not reduce depression or change mood scores over a median of 5.3 years. That trial looked at prevention, so it does not settle what happens in someone with a real deficiency and active depression. It does argue against assuming that a borderline number explains how you feel.
Ferritin is a similar story. A low value may mean iron deficiency anemia or another condition related to low iron, and symptoms of low iron can include weakness or fatigue. But inflammation can raise ferritin, so a normal-looking number is not always the end of the question. For more on telling these apart, see depression or nutrient deficiency.
Blood sugar and cholesterol
A1C shows your average blood sugar over the past two to three months. Fasting glucose and a lipid panel are often paired with it. These tests have a clear job when a medication can affect metabolism. The olanzapine label, for example, calls for fasting blood glucose testing at the beginning of treatment and periodically during treatment, along with baseline and follow-up lipid evaluations and regular weight checks. Antipsychotics differ markedly in their metabolic side effects, so these numbers can inform a real decision.
Whether blood sugar patterns explain depression or anxiety in people not taking these drugs is a more open question. The newer field exploring it is covered in what is metabolic psychiatry.
Tests that keep medication safe
Some drugs need monitoring regardless of the care model. Lithium is the clearest example. Its label carries a boxed warning about lithium toxicity, and it says to monitor thyroid function before starting, at three months and every six to twelve months, and it also calls for checks of kidney function, calcium and lithium levels. These tests are a basic part of safe prescribing. Our separate article on which blood tests psychiatric medications need covers this by drug class.
Inflammation markers: interesting research, limited clinical use
A meta-analysis pooling 30 studies found that about a quarter of people with depression show low-grade inflammation on CRP testing. That is why some clinicians are interested in it. The result still has limits for one person. MedlinePlus explains that CRP shows how much inflammation you have, but not what's causing it or where it is. An infection, an injury or another illness could all raise it. A high CRP is a reason to look further, and it does not by itself show that inflammation is causing your mood symptoms.
Cortisol and "adrenal fatigue" panels
A cortisol test has a defined medical use: to help diagnose or rule out conditions that cause too much or too little cortisol, such as Cushing syndrome and Addison disease. Stress and exercise can raise the level, so an unusual result does not always mean a medical condition.
Repeated saliva cortisol tests are sometimes sold as a way to diagnose "adrenal fatigue." A 2016 systematic review of 58 studies found conflicting results and concluded there is no substantiation that adrenal fatigue is an actual medical condition. Stress affects the body in real ways, as our piece on hormones, cortisol and chronic stress describes, but that label is not an established diagnosis.
Genetic testing for medication choice
Pharmacogenomic panels look at genes that affect how the body handles certain drugs. The FDA keeps a table of pharmacogenetic associations that includes several psychiatric medications, such as citalopram and aripiprazole. The FDA also says that being listed does not necessarily mean it advocates testing before prescribing, and that most associations have not been evaluated for how testing affects clinical outcomes. In 2019 it sent a warning letter to a genomics lab over tests claiming to predict responses to specific named drugs, including antidepressants.
One large trial, PRIME Care, enrolled 1,944 patients with major depression at Veterans Affairs medical centers. Test results shifted prescribing away from drugs with predicted interactions, but the authors described small nonpersistent effects on symptom remission, with no significant difference at 24 weeks. A 2026 review of eight trials found modest short-term gains for one commercial platform and imprecise results for other panels, and it noted risk-of-bias concerns. The authors said this should not be read as showing that one commercial test is better than others. A fair summary: results can add information to a prescribing conversation, and they do not identify "the right" medication.
Specialty and functional panels
Some practices offer food sensitivity panels, urine neurotransmitter tests and broad "root cause" profiles. Our article on whether specialty functional lab tests are worth it looks at these one by one. MTHFR gene testing is a common example of how a finding can outrun its evidence. A medical genetics guideline found the test has minimal clinical utility in the clotting workups it was frequently ordered for. That guideline does not address mood, so it does not settle the psychiatric question, but it is a good reason to ask what a result would change.
Questions to ask before any test
- What specific question will this test answer for me?
- What would we do differently if it came back high, low or normal?
- Is this a standard medical test, or a specialty panel with weaker validation?
- What will it cost, and is it likely to be covered?
- Do any of my supplements affect the result?
That last question matters. The FDA warns that biotin, often found in dietary supplements, can significantly interfere with certain lab tests. List everything you take before a blood draw, and do not stop a prescribed medication for a test unless your clinician tells you to.
What to expect from a thoughtful approach
A careful clinician usually starts with your history, then picks tests that fit it and reads the results alongside your symptoms. A long panel can produce borderline findings that lead to more testing, more supplements and more cost, with no clearer answer. Sharing recent results from your primary care doctor can also prevent repeat testing. If you are unsure who should order what, see whether to see your primary care doctor or a psychiatrist first.
To learn how this fits into care at Mind Body Seven, read about integrative psychiatry. Questions about specific tests go to the intake team, and fees and insurance explains how costs work.
FAQs
Is there a blood test for depression or anxiety?
No. Blood work cannot diagnose a mental health disorder. Diagnosis rests on a clinical evaluation, and labs help check for physical conditions or medication effects that may be involved.
Will insurance pay for these tests?
It varies by test, plan and reason for ordering. Standard tests ordered for a medical reason are often handled differently from specialty panels. Ask your insurer and the lab before the draw, and see fees and insurance for how the practice handles out-of-network care.
Which lab tests does Mind Body Seven order?
This article does not list a set panel. Ask the intake team when you request a consultation.
Can I order my own tests online and bring the results?
Ask the intake team whether outside results can be used. Results from a direct-to-consumer panel may still need to be repeated or put in context, so ask before paying for one.
