Built from critical-care diagnostic discipline and outpatient psychiatric practice • Decision support, not rigid medical orders

Clinical Protocols

Symptom-Based Diagnostic Workups

6 symptom protocols. 8 specialized panels. 29 biomarkers analyzed. A structured way to ask what medical contributors may be driving psychiatric presentations.

How to read these protocols

These protocols are educational decision-support frameworks. They do not replace clinical judgment, local standards, payer rules, or referral to the right medical specialty when a pattern points outside psychiatry.

Symptom Protocols

Each protocol includes Tier 1 screening, Tier 2 escalation logic, and clinical guardrails. One sample protocol is public below so the method is visible before any training program exists.

01

Depression / Low Mood

Common Medical Causes:
  • Hypothyroidism
  • Anemia
  • B12 Deficiency
  • Chronic Inflammation
  • +2 more...
View public sample
02

Anxiety / Agitation

Common Medical Causes:
  • Hyperthyroidism
  • Hypoglycemia
  • Medication-Induced
  • +4 more...
Training protocol reserved
03

Fatigue / Low Energy

Common Medical Causes:
  • Sleep Apnea
  • Iron Deficiency
  • Vitamin D Deficiency
  • +5 more...
Training protocol reserved
04

Cognitive Changes

Common Medical Causes:
  • B12 Deficiency
  • Hypothyroidism
  • Sleep Apnea
  • +4 more...
Training protocol reserved
05

Sleep Disturbances

Common Medical Causes:
  • Restless Legs Syndrome
  • Sleep Apnea
  • Iron Deficiency
  • +3 more...
Training protocol reserved
06

Psychosis

Common Medical Causes:
  • Substance-Induced
  • Autoimmune Encephalitis
  • B12 Deficiency
  • +4 more...
Training protocol reserved

Public sample

Public sample protocol: Depression / Low Mood

This sample shows the structure. It is not a standing order set and it does not diagnose depression from labs.

Tier 1

Baseline screen when depression is persistent, atypical, or not responding as expected.

  • PHQ-9 with suicide-risk review when indicated
  • Timeline: onset, episodic pattern, treatment trials, medication changes, substances, sleep, medical events
  • TSH with reflex free T4 when thyroid symptoms, treatment resistance, fatigue, cold intolerance, or weight change fit
  • CBC with indices and ferritin when fatigue, restless legs, heavy menses, low intake, pregnancy/postpartum, or endurance training fit
  • B12 with methylmalonic acid when neuropathy, cognitive symptoms, restrictive diet, metformin, acid suppression, or macrocytosis fit
  • CMP, HbA1c, lipid panel, and medication/metabolic review when weight, appetite, sedation, antipsychotic exposure, or metabolic risk fit
Tier 2

Escalate only when symptoms, history, exam, or prior results make the question plausible.

  • Sleep study referral when snoring, witnessed apneas, non-restorative sleep, morning headaches, hypertension, or daytime sleepiness fit
  • Thyroid antibodies or expanded thyroid review when autoimmune history, goiter, fluctuating symptoms, postpartum onset, or family history fit
  • Inflammation or autoimmune review when pain, fevers, rashes, bowel symptoms, neurologic signs, or systemic illness fit
  • Hormone/endocrine routing when menstrual irregularity, androgen symptoms, low libido, infertility history, hypercalcemia, or Cushingoid features fit
Guardrails

The protocol keeps psychiatric diagnosis and medical context in the same frame.

  • Primary depressive disorder stays on the differential. Medical contributors do not erase psychiatric diagnosis.
  • One abnormal lab does not explain the presentation by itself.
  • Normal reference ranges can still leave a clinical question unanswered when the symptom pattern is strong.
  • Medication and supplement changes require the treating clinician.
  • Suicidality, psychosis, mania, withdrawal, delirium, severe medical symptoms, or acute safety concerns bypass this framework and need urgent care pathways.

Specialized Lab Panels

8 panels (A-H) with CPT codes, clinical target ranges, and indications.

Panel A Endocrine 3 tests
Panel B Iron 4 tests
Panel C Inflammation 2 tests
Panel D Vitamins 5 tests
Panel E Reproductive 5 tests
Panel F Thyroid Autoimmunity 2 tests
Panel G Infectious/Exposure 6 tests
Panel H Therapeutic Drug Monitoring 2 tests
Coming 2026

Diagnostic Psychiatry training

Additional protocols, panel details, and training materials are being developed for clinicians who want a structured way to practice this differential-first method.

No spam. Only CDxP updates and early access.

What's Included in Full Access

Full Protocols

Tier 1 and Tier 2 workups for every symptom presentation

Lab Panel Details

CPT codes, clinical target ranges, and interpretation guidance

Clinical Pearls

Expert insights that don't appear in standard guidelines

CDxP Certification

Training to master diagnostic psychiatry methodology