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Targeted Assessment · Nutritional Psychiatry · Mental Health

The Nutritional Investigation
Before — or Alongside —
Psychiatric Treatment

Before the antidepressant prescription, nobody checked B12 functional status, methylfolate adequacy, zinc, EPA omega-3, vitamin D, ferritin, CRP, or thyroid antibodies. These are documented, measurable, correctable nutritional drivers of depression, anxiety, and psychiatric medication response.

B12 & MTHFRCritical for neurotransmitter synthesis — often missed
Inflammatory subtypeCRP identifies those who respond to anti-inflammatory approach
Thyroid antibodiesHashimoto's is a common missed cause of depression
£365Full nutritional psychiatry assessment
Who this is for

People experiencing depression, anxiety, or cognitive symptoms — with or without current psychiatric treatment

The serotonin deficiency model of depression has been significantly questioned by the published literature (Moncrieff et al., Molecular Psychiatry, 2022). What is increasingly clear is that depression is frequently a multi-system biological problem with significant nutritional, inflammatory, methylation, and gut microbiome components that are specific to the individual. This assessment maps those components.

What we assess

The markers that aren't being checked

B12 functional status
Serum B12 misses functional deficiency. Homocysteine and methylmalonic acid are more sensitive. B12 deficiency produces depression, anxiety, and cognitive impairment before haematological changes appear.
B12 deficiency is significantly more common than serum testing suggests — especially in those on PPIs, vegans, and those over 60.
MTHFR / Methylfolate
Antidepressant non-response is significantly higher in MTHFR variant carriers. The methylation cycle that produces SAMe — required for neurotransmitter synthesis — is impaired. Methylfolate (not folic acid) is the correct intervention. L-methylfolate is FDA-approved as adjunctive treatment for depression specifically because of this mechanism.
40% of people have variants reducing MTHFR activity by 35–70%.
Zinc
Modulates NMDA receptors — the same system ketamine targets. Meta-analysis of 17 studies: significantly lower zinc in depressed individuals. Multiple RCTs show zinc augmentation improves antidepressant response in treatment-resistant cases.
Serum zinc is insensitive. Functional deficiency is underdetected.
EPA omega-3 (above 1g)
Anti-inflammatory mechanism. Most effective in inflammatory-subtype depression (elevated CRP). High-EPA formulations at therapeutic dose outperform standard fish oil in RCTs.
CRP — inflammatory subtype
Elevated CRP identifies inflammatory-subtype depression — where anti-inflammatory interventions are the primary clinical need. SSRIs have minimal anti-inflammatory effects. Getting this distinction right changes the treatment approach substantially.
Full thyroid — TSH, free T3, TPO, TgAb
Subclinical hypothyroidism and Hashimoto's are among the most common and consistently overlooked causes of depression. TSH above 2.5 is associated with reduced IVF success, increased miscarriage risk, and mood disorder. Antibodies may be elevated with normal TSH — and still causing immune-mediated depression.
Every woman presenting with new-onset depression should have thyroid antibodies checked before an antidepressant is prescribed. This is not standard practice.
Ferritin
Ferritin below 30 µg/L impairs dopamine synthesis (iron is required for tyrosine hydroxylase). Depression, fatigue, and cognitive slowing in iron-insufficient women is frequently treated with antidepressants rather than iron. The NHS "normal" lower limit of 13–15 µg/L is clinically catastrophic for neurological health.
Vitamin D
Vitamin D receptors are expressed throughout the brain. Deficiency independently associated with depression — largest effects in severely deficient populations.
Targeted Assessment Service
DH Mental Health Nutritional Assessment
Complete nutritional and inflammatory assessment · MTHFR status · Thyroid panel including antibodies · Written report with specific intervention priorities
What's included
Blood chemistry — B12, homocysteine, folate, zinc, vitamin D, ferritin, CRP, fasting glucose/insulin, full thyroid panel (TSH, free T3, free T4, TPO, TgAb)
MTHFR variant status — determines whether methylfolate or folic acid is appropriate
Omega-3 index — EPA:DHA ratio and clinical adequacy
Written interpretation report with ranked intervention priorities
Specific supplement protocol including forms, doses, and timing
Drug-nutrient interaction review for those on existing psychiatric medication
What you'll know
Whether MTHFR variants are impairing neurotransmitter synthesis — and what form of folate to use
Inflammatory load (CRP) — whether your presentation is inflammatory-subtype requiring anti-inflammatory intervention
Full thyroid picture including antibodies — Hashimoto's as a potential missed cause
Ferritin status against functional neurological thresholds, not NHS statistical thresholds
Zinc and EPA omega-3 status against therapeutic targets
A specific nutritional intervention plan — as a standalone approach or alongside existing treatment
Assessment fee
£365
Lab costs additional where applicable.
Book a Discovery Call →
Further reading

The clinical evidence behind this service

Clinical Essay
What Your Psychiatrist Isn't Telling You
Clinical Essay
Stress Is a Biochemistry Problem, Not a Willpower Problem
The Gap Series
Normal Is Not the Same as Optimal
Test
Blood Chemistry — The Markers That Matter

Not sure where to start?

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Describe your situation — the concierge can help clarify what investigation makes most sense for your specific picture.

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