The Role of Bloodwork in Psychiatric Evaluation

You’ve made an appointment to see a psychiatrist to talk about your mood and anxiety. You expect to be asked a lot of questions about your feelings. But you might be surprised when one of the first things your new doctor recommends is that you go to a lab to get some blood drawn. Why would a psychiatrist be interested in your blood? It might seem strange, but ordering bloodwork is often a standard and very important part of a thorough initial psychiatric evaluation.

At Televero Health, we practice with the understanding that your mental health and your physical health are fundamentally linked. Before we can confidently treat a psychiatric condition, we must first make sure that your symptoms aren’t being caused or made worse by an underlying medical problem. Bloodwork is one of our most important tools for doing just that.

Ruling Out Medical Masqueraders

Many physical health conditions can “masquerade” as psychiatric ones, producing symptoms that look almost identical to those of depression, anxiety, or even psychosis. Your psychiatrist is trained to be a good medical detective, and ordering blood tests helps them to rule out these other possibilities. This process is a key part of making an accurate differential diagnosis.

Some of the most common things a psychiatrist will look for in your bloodwork include:

• Thyroid Function: This is one of the most common and important things to check. Your thyroid gland produces hormones that regulate your body’s metabolism, and they have a powerful effect on your brain.
  • An underactive thyroid (hypothyroidism) can cause fatigue, weight gain, poor concentration, and depression.
  • An overactive thyroid (hyperthyroidism) can cause anxiety, restlessness, a racing heart, insomnia, and even panic attacks.

  A simple blood test called a TSH (Thyroid-Stimulating Hormone) test can screen for thyroid problems.

• Complete Blood Count (CBC): A CBC looks at the different cells in your blood. It can detect conditions like anemia (a low red blood cell count), which reduces the amount of oxygen getting to your brain and can cause profound fatigue and symptoms of depression.
• Vitamin Deficiencies: Your brain needs a steady supply of certain vitamins to function properly. Deficiencies in some key vitamins can lead to psychiatric symptoms. Common ones to check include:
  • Vitamin B12: A deficiency can cause fatigue, depression, and even memory problems.
  • Vitamin D: Low levels of Vitamin D have been strongly linked to depression.
• Electrolyte and Kidney Function: A basic metabolic panel can check the levels of electrolytes like sodium and calcium in your blood, as well as how well your kidneys and liver are functioning. Imbalances in these areas can sometimes cause changes in your mental state.

Establishing a Baseline for Medication

Bloodwork is not only important for diagnosis, but also for treatment. Before starting certain psychiatric medications, your doctor will want to establish a baseline of your blood counts and your liver and kidney function. This is because some medications can, in rare cases, affect these systems. Having a baseline allows your doctor to monitor your bloodwork over time to make sure the medication is not causing any problems.

For some specific medications, like lithium or valproic acid, regular blood tests are a required part of treatment. These tests are used to make sure the level of the medication in your blood is within a narrow therapeutic range—high enough to be effective, but not so high that it becomes toxic.

A Sign of Thorough Care

If your psychiatrist recommends bloodwork, it is a sign that they are being thorough and are taking a comprehensive, whole-person approach to your health. They are doing their due diligence to ensure that they have all the necessary information to make an accurate diagnosis and to create a treatment plan that is both safe and effective for you.

By ruling out other medical causes for your symptoms, your doctor can be more confident that you are getting the right treatment for the right problem, which is the essential first step on your path to feeling better.

Key Takeaways

• Ordering bloodwork is a standard and important part of a thorough psychiatric evaluation.
• It is used to rule out underlying medical conditions, such as thyroid problems or vitamin deficiencies, that can cause or worsen psychiatric symptoms.
• Blood tests are also used to establish a baseline before starting certain medications and to monitor for safety during treatment.
• A recommendation for bloodwork is a sign of good, comprehensive care, ensuring your diagnosis is accurate and your treatment is safe.

Ready to take the first step? We can help. Get started with Televero Health today.