You have labs, but not a clinical map
Red marks, borderline values, or normal results are sitting next to mood, focus, sleep, energy, or anxiety symptoms without a clear interpretation.
Diagnostic Psychiatry
Psychiatric symptoms, read in medical context.
A structured psychiatry-medicine review that connects symptoms, labs, sleep, medications, supplements, screening scores, and timeline before the differential is narrowed too early.
11
clinical inputs organized
4
routing outcomes named
No
single-lab diagnoses
Pattern, not a single marker
Medical context changes how psychiatric symptoms are read.
The review does not treat a lab value as the answer. It asks whether thyroid status, iron stores, sleep oxygen, B12, medications, substances, and timeline make the psychiatric differential wider or narrower.
Symptoms Labs Sleep Medications
Who it is for
For people whose symptoms, labs, and history need to be read together.
You function, but feel below baseline
Work, family, and responsibilities are still moving, but your clarity, stamina, motivation, or resilience feels meaningfully different.
You have tried psychiatric care, but the pattern still feels unfinished
Medication trials, therapy, screening scores, or prior diagnoses helped define severity, but did not explain what may be driving the whole presentation.
Visual workup
The review turns scattered health data into a clinical map.
Symptoms, labs, sleep, medications, and timeline are placed into one frame so the output can separate psychiatric care, medical follow-up, specialty referral, and monitoring.
What the patient feels
- Panic
- Fatigue
- Brain fog
- Poor focus
What can shift the differential
- TSH / T4 / T3
- Ferritin
- B12 / MMA
- HbA1c
What changes interpretation
- Sleep
- Medication timing
- Supplements
- Substances
Where the finding belongs
- Psychiatry
- Primary care
- Specialist
- Monitor
What comes into the review
The data is only useful when the pattern is interpreted.
Thyroid panelIron and ferritinB12, folate, vitamin DGlucose and HbA1cAM cortisolPHQ-9GAD-7Insomnia severityMedications and supplementsSleep, caffeine, alcohol, substancesSymptom timeline and prior treatment
These are inputs, not answers. A thyroid value does not diagnose anxiety. A PHQ-9 score does not rule out a medical contributor. The review reads labs beside symptoms beside medications beside sleep, then decides what belongs in the differential.
Pattern lens
The pattern decides whether the signal matters.
The useful work happens when labs are read beside symptoms, medication timing, sleep, substances, and the timeline.
- Fatigue plus ferritin reads differently than ferritin alone.
- Panic plus thyroid symptoms changes the thyroid question.
- Brain fog plus sleep risk changes the next step.
The review is structured
Four steps. No guessing dressed up as certainty.
01
Assemble the record
Labs, symptom timeline, medication trials, sleep pattern, supplements, substance use, PHQ-9, and GAD-7 scores are pulled into one clinical record.
02
Overlay labs on symptoms
TSH gets read beside fatigue and weight change. Ferritin beside focus. B12 beside cognition. The diagnostic work happens in the overlay.
03
Widen the differential
What looks psychiatric may also involve sleep apnea, hypothyroidism, a medication effect, a nutritional deficit, or a combination.
04
Name the next step
Each finding gets a pathway: further testing, referral, continued psychiatric care, monitoring, or no medical action.
Route the finding
The output is a responsible next-step map.
A finding may support ongoing psychiatric care, require primary-care follow-up, need specialty review, or simply be monitored. The point is to name the route without turning every signal into a diagnosis.
Clinical guardrail
This work has a lane. Three things it is not.
It is not lab optimization. It is not single-cause certainty. It is not anti-psychiatry. Antidepressants, mood stabilizers, stimulants, and psychotherapy can be legitimate endpoints of a careful workup. The job is to interpret labs, symptoms, sleep, medications, and history together, including cases where no medical change is needed.
Evidence discipline
A claim is not useful until you know how strong it is.
Diagnostic Psychiatry separates established medical mimics from supported associations, proposed framework concepts, and early mechanisms. That keeps the differential wide without turning every lab value into an answer.
Established
Strong guideline, replicated review, or clear disease mechanism. Still interpreted in context.
Supported
Good evidence and clinical plausibility, but not definitive for every patient or setting.
Proposed
Framework-level reasoning or emerging mechanism. Useful for the differential, not proof.
Speculative
Too early for patient-facing action unless it is clearly labeled and bounded.
Standard workup. Symptom-triggered workup.
A standard psychiatric intake is narrow by design. A symptom-triggered review asks what medical, sleep, medication, and nutritional contributors should stay in the differential before the pattern is narrowed too early.
Diagnostic Coverage
Standard Care
Baseline- CBC
- Basic Metabolic Panel
- Ferritin Considered in review
- Iron Panel (TIBC, Saturation) Considered in review
- Full Thyroid (TSH, Free T3, T4, RT3) Considered in review
- Vitamin D, 25-OH Considered in review
- B12 & Folate Considered in review
- Cortisol (AM) Considered in review
- Sleep Study Screening Considered in review
Diagnostic Psychiatry
Expanded- CBC
- Basic Metabolic Panel
- Ferritin +
- Iron Panel (TIBC, Saturation) +
- Full Thyroid (TSH, Free T3, T4, RT3) +
- Vitamin D, 25-OH +
- B12 & Folate +
- Cortisol (AM) +
- Sleep Study Screening +
+0 additional inputs considered
Standard care for chronic fatigue checks 2 tests. This framework reviews 9 when the history and presentation support an expanded differential.
Inside the range is not the same as answered.
Reference ranges describe a population, not a person. When symptoms are present, a value near the edge of normal is still a signal to interpret, not a closed question.
TSH (Thyroid) 3.8 mIU/L
Context Zone: in range, still worth interpreting
Reference range
Context zone
Clinical target
Drag the slider to explore different values
Standard Reference Range 0.4 – 4.5 mIU/L
Built from population data to flag overt thyroid disease. A value inside this band can still belong in the differential when symptoms point there.
Narrower Clinical Window 1.0 – 2.5 mIU/L
A tighter band sometimes used in symptomatic interpretation. It is a reason to look more carefully, not a target everyone needs to hit.
Illustrative composites · not specific patients · not outcome predictions
Patterns the review surfaces.
Illustrative composites, not patient stories. Each pattern shows the original psychiatric frame, the medical signal that should stay in the differential, and the routing question that follows.
If you are in crisis or considering harming yourself, call or text 988 in the US, or go to
your nearest emergency department. This page is not emergency care.
Pattern 001 Composite
Initial psychiatric frame
Treatment-resistant anxiety, panic attacks
What the review adds
Thyroid autoimmunity
TPO Antibodies: 847 IU/mL (normal <35)
Routing question: does thyroid evaluation need to run alongside psychiatric care before another medication trial?
Pattern 002 Composite
Initial psychiatric frame
ADHD symptoms, inability to focus
What the review adds
Severe iron deficiency
Ferritin: 12 ng/mL (low iron stores)
Routing question: should iron status, source of deficiency, and primary care follow-up be addressed before further stimulant escalation?
Pattern 003 Composite
Initial psychiatric frame
Depression, fatigue, weight gain
What the review adds
Subclinical hypothyroidism
TSH: 4.2 mIU/L, Free T3: low
Routing question: should thyroid status be reassessed before the case is treated as purely treatment-resistant depression?
See how antidepressants affect metabolism →Composites are illustrative of diagnostic patterns drawn from peer-reviewed literature on medical mimics in psychiatry. They are not testimonials, not specific patient stories, and not predictive of any individual response.
Educational tools for better clinical conversations.
Tools on this site surface patterns to discuss with a provider. They do not diagnose, prescribe, or replace clinical judgment.
New
→ Antidepressant Metabolic Guide
Compare weight, cardiovascular, and liver-enzyme signals for common antidepressants using published evidence summarized for provider discussion.
More Tools Coming
Lab-pattern explainers, symptom-to-system maps, and medication review aids are in development under the tool credibility rubric.