Why Bloodwork Matters When You’re Struggling With Anxiety or Depression

Have you ever gone to a doctor for anxiety or depression and walked out with a prescription but no bloodwork? If so, you’re not alone. This approach is surprisingly common in our healthcare system, but it misses a critical piece of the healing puzzle.

The Missing Piece in Mental Health Care

When we experience anxiety or depression, we often assume it’s solely a mental health issue or it get’s labeled as a “chemical imbalance” (which, by the way, was debunked awhile ago read here to learn more). But oftentimes your symptoms are actually signals that something is physiologically out of balance in your body.

The Physiology-First Approach

At Regulated Living, we advocate for a physiology-first (not physiology-only) approach to mental health. Here’s why:

1. Your body affects your brain: When your body is stuck in survival mode, has imbalanced hormones, is undernourished or under-rested, overstressed, or unwell, it literally changes the way your brain works.
2. You can’t think your way out of physiological imbalance: There’s no amount of talk therapy or mindset work that can outplay a nervous system stuck in survival mode or a physiologically depleted and imbalanced body.
3. Data-driven healing is more efficient: Comprehensive bloodwork takes the guesswork out of healing. Instead of arbitrary supplement, medication, or lifestyle suggestions, you get recommendations specific to YOUR unique body.

Why Standard Bloodwork Isn’t Enough

Many of my clients have had the frustrating experience of being told their bloodwork is “normal” despite feeling terrible. Here’s why that happens:

1. Limited testing: Many providers run only basic panels that miss key markers relevant to mental health.
2. Disease-focused reference ranges: Standard medical reference ranges are designed to identify disease states, not optimal function. You can be “within range” but nowhere near your personal optimal function.

Let me give you a concrete example: The standard reference range for vitamin B12 in many labs goes as low as 200 pg/mL. But research shows neurological symptoms often appear below 500 pg/mL, and many functional medicine practitioners aim for levels above 800 pg/mL for optimal brain function.

This pattern repeats across numerous markers – thyroid hormones, vitamin D, iron, and inflammatory markers. The gap between “normal” and “optimal” is where many people get stuck in a limbo of continuing symptoms without clear medical diagnosis.

Key Areas That Affect Mental Health

Based on research and clinical experience, here are some of the most important areas to assess through bloodwork when you’re experiencing anxiety or depression:

1. Thyroid Function

Thyroid disorders are one of the leading causes of undiagnosed mental health issues. An overactive thyroid can make you feel sped-up and anxious, while an underactive thyroid typically leads to lower brain activity, which can cause depression, brain fog, or irritability. (Amenclinics)

Researchers have long recognized the link between thyroid function and depression, although the exact mechanisms aren’t fully understood. Studies suggest that TSH levels correlate to the severity of depressive symptoms, and even mild thyroid imbalances (subclinical hypothyroidism) may contribute to depression. (Verywell Mind)

2. Vitamin Status

Multiple nutrient deficiencies can contribute to anxiety and depression:

1. Vitamin B12: Low levels of vitamin B12 and other B vitamins may be linked to depression, and vitamin levels can be checked using a blood test. (Mayo Clinic) B12 is essential for neurotransmitter production and energy metabolism.
2. Vitamin D: Research shows that improvement in Vitamin D levels is significantly associated with improvement in depression scores, particularly in those with Seasonal Affective Disorder (SAD). Studies have identified that up to 90% of those admitted to a psychiatric unit are low in vitamin D.
3. B Vitamins: B6 and folate are essential for neurotransmitter production. Folate deficiency is relatively common in depressed people, with approximately one-third of depressed individuals having an outright deficiency. (One Life)

3. Hormone Balance

Hormones are chemical messengers that influence virtually every aspect of your physical and mental health. Imbalances can manifest as anxiety, depression, fatigue, sleep disturbances, and mood swings.

Even mild hormonal imbalances can present primarily as depression and brain fog, while hormonal fluctuations often drive anxiety symptoms, especially in women.

4. Inflammation Markers

Chronic inflammation is increasingly recognized as a driving factor in depression, anxiety, and cognitive issues. High CRP (C-reactive protein) blood tests can indicate inflammation that may contribute to mood disorders. (PI Therapy)

Research now shows that many cases of depression may actually be inflammatory conditions affecting the brain, which explains why conventional antidepressants often don’t fully resolve symptoms.

5. Metabolic Health

Your brain consumes about 20% of your body’s energy, making metabolic health crucial for cognitive and emotional wellbeing. Key markers include:

• Blood sugar regulation (fasting glucose, insulin, HbA1c)
• Leptin resistance
• Lipid profiles

Blood sugar instability is one of the most common yet overlooked drivers of anxiety symptoms, creating a physiological stress response that mimics anxiety disorders.

The Stress Bucket Concept

Remember the stress bucket concept? Think of your nervous system like a bucket that can only hold so much stress. Any physiological imbalances or deficiencies happening inside your body add stress to this bucket. When we can identify and address these imbalances through targeted interventions based on bloodwork, it reduces the overall stress load.

This gives you:

1. More capacity for daily life before your stress bucket overflows
2. More stability and capacity to do any needed deeper healing work
3. Decreased intensity of symptoms in a strategic and data-driven way

What Comprehensive Testing Should Include

A truly comprehensive panel for anxiety and depression should include:

• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel (CMP)
• Lipid panel
• Vitamin D, B12, folate (potentially other vitamin & mineral testing)
• Ferritin and iron
• Inflammatory markers (CRP, ESR)
• Full thyroid panel (TSH, free T3, free T4, thyroid antibodies)
• Hormone testing
• Blood sugar markers

Depending on your specific situation, additional testing might include:

• Food sensitivity testing
• Advanced gut health assessment
• Heavy metal screening
• Specialized hormone testing
• Genetic testing

It’s Time for a New Standard of Mental Health Care

I wish it was standard practice that before being prescribed psych meds, people were offered comprehensive bloodwork and asked basic questions about their stress levels, relationships, diet, movement habits, hormones, and sleep.

Symptom management is only PART of the solution, but when it is presented AS the solution, everyone suffers. The very symptoms that medications suppress might be the ones pointing you toward ways of improving your health.

The biggest problem I’m trying to solve for with Regulated Living is the fragmentation of mainstream mental health approaches. Your mental health symptoms are not separate from your physical health. Optimizing your labs isn’t the only thing you’ll likely need to do to heal, but it might be a key piece for you as it has been for many people.

Taking Action: What You Can Do

If you’re struggling with anxiety or depression, here are some steps you can take:

1. Request comprehensive bloodwork: Advocate for yourself with your healthcare provider. If they’re reluctant, consider seeking out a functional medicine doctor, naturopath, or integrative psychiatrist. This is also something we include for all of our Restore clients.
2. Look beyond “normal” ranges: Ask for copies of your lab results and research optimal ranges rather than just clinical cutoffs.
3. Consider the whole picture: Remember that mental health is affected by physiological, psychological, and social factors. A comprehensive approach addresses all three.
4. Seek personalized support: Find practitioners who take a whole-human, whole-life approach and who understand the connection between physical and mental health. We’d love to support you.

What I’ve observed in working with clients is that healing doesn’t mean doing more—it means doing what’s right for YOU. Comprehensive bloodwork gives you vital information about what’s going on “under the hood” in your body, allowing for a targeted, personalized approach to healing.

Your mental health deserves this level of detailed care and attention. You’re not just a collection of symptoms to be managed—you’re a whole person whose body and mind work together in complex ways. By understanding the physiological factors that might be contributing to your anxiety or depression, you open up new pathways to healing and thriving.

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This blog post is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.