Sometimes. A licensed naturopathic doctor (ND) can order lab tests only if the state's practice law allows it, and the rules differ by state. California's naturopathic board, for example, confirms that licensed NDs there may order diagnostic tests. New York doesn't license NDs at all, and three states ban naturopathic practice. Before you pay for tests, ask the practice who will sign the lab order and under what license.
Who can order lab tests: it depends on the state
Naturopathic doctors are licensed or registered in 23 states, plus Washington, D.C. and Puerto Rico. Each state's law sets what they can do. Where there's no ND license, there's no state ND scope of practice to rely on.
| State status | Examples | What it means for lab tests | Source |
|---|---|---|---|
| Licensed | Arizona, California, Oregon, Vermont, Washington and others | The state practice law sets the scope. Most licensing laws name lab testing (see the list below). Massachusetts NDs may order lab tests and X-rays, but can't interpret imaging or perform tests they aren't separately licensed to do. Alaska's and Maryland's laws don't name lab testing. | California Board of Naturopathic Medicine, 2026 report; Massachusetts board guidance, 2024 |
| Registered | Colorado, Minnesota, Pennsylvania | Colorado registered NDs may order clinical, laboratory and radiological diagnostic tests from licensed facilities or labs, but may not prescribe controlled substances. Minnesota registered NDs may order clinical lab tests and perform CLIA-waived tests; imaging is referred out. Pennsylvania registers NDs, but we found no published count of registrations or lab-ordering rule; ask the state regulator. | C.R.S. 12-250-106; Minn. Stat. 147E.05 |
| Not regulated | New York, New Jersey, Texas and 21 other states | No ND license exists. In New York, the national ND association says NDs can work only as consultants. | AANP, 2022 |
| Banned | Florida, South Carolina, Tennessee | Practicing naturopathy is illegal, so no ND scope applies. | Fla. Stat. § 462.17; S.C. Code § 40-31-10; Tenn. Code § 63-6-205 |
We read the licensing laws on October 10, 2026. In these places, the law names lab testing or ordering:
- Oregon: ordering diagnostic tests (ORS 685.030).
- Vermont: clinical laboratory tests and examinations (26 V.S.A. 4121).
- Maine: clinical laboratory tests. NDs may order ultrasound, X-rays and ECGs, but must refer them out to be done and read (32 M.R.S. 12522).
- New Hampshire: clinical laboratory tests and examinations (RSA 328-E:4).
- Kansas: laboratory tests as a diagnostic method (K.S.A. 65-7202).
- Hawaii: venipuncture and laboratory medicine as common diagnostic procedures (HRS 455-1).
- Wisconsin: clinical laboratory tests (Wis. Stat. 466.01(6)(a)).
- Montana: ordering clinical lab tests and phlebotomy (MCA 37-26-301).
- California: the board's manual says NDs order lab tests and imaging and do CLIA-waived tests in the office (CBNM 2026 report).
- Puerto Rico: NDs may refer patients for diagnostic tests, including clinical lab tests and phlebotomy (Law 208 of 1997, Art. 15).
Alaska's ND law (AS 08.45) has no diagnostic or lab clause. Maryland's law defines diagnosis but names no lab tests (Health Occ. 14-5F-01). Arizona's law includes diagnosing, but mentions lab tests only in its rules on dispensing minerals (A.R.S. 32-1581). In those states, and anywhere the rule isn't clear, ask who signs the lab order.
California's naturopathic practice act had been set to end on January 1, 2027 (CBNM 2026 report). SB 1303 was signed on September 20, 2026, as Chapter 430 of 2026, and amended section 3686 of the Business and Professions Code to move that date to January 1, 2031 (SB 1303 status).
Massachusetts, which has licensed NDs since 2022, is another state with written guidance. Its board says an ND may order a test but may perform it only if separately licensed for that test, and may order X-rays but not interpret them. The guidance quotes the state's scope rule, which allows licensed naturopaths to order clinical and laboratory procedures from licensed clinics or laboratories (273 CMR 4.02(1)(b)). The same rule bars them from prescribing controlled substances and prescription drugs under the state's chapter 94C.
For the full list, see states where naturopathic doctors are licensed.
If you're in New York
New York doesn't license NDs, and a pending bill notes that anyone there may use the title (S8714). If a New York practice offers lab testing, ask which licensed clinician (MD, DO, NP or PA) orders the tests and reviews the results, and check that license with NYSED license verification.
Licensed ND or traditional naturopath?
Licensed NDs graduate from a doctoral program accredited by the Council on Naturopathic Medical Education, which requires at least four academic years and 1,200 hours of clinical training (CNME, September 2025), and pass national board exams. Traditional naturopaths train in non-accredited programs and aren't eligible for a license (NCCIH). A traditional naturopath holds no state ND license, so no state ND scope of practice covers them.
Hormone testing
Hormone tests are lab tests, so the same rules apply: state scope, a named clinician who signs the order, and your plan's coverage. If a practice offers hormone testing, ask:
- Which hormones, and why those?
- Blood, saliva or urine sample, and why that method?
- Will my primary care doctor or gynecologist accept the results, or will they need to repeat them?
- What would change in my treatment depending on the result?
- What does each test cost, and is it billed through insurance or as a cash test?
For the tests doctors usually run first for thyroid, PCOS and perimenopause symptoms, see hormone testing for hormonal imbalance.
What happens after a hormone test also depends on the state. California lets licensed NDs prescribe hormones without physician oversight (Cal. Bus. & Prof. Code § 3640.7(b)). Hawaii's ND formulary includes hormones except testosterone (Hawaii formulary). Washington NDs can prescribe testosterone products (RCW 18.36A.020). An ND in New York can't prescribe. See what naturopathic doctors can prescribe, state by state. For thyroid tests specifically, see what thyroid guidelines say about testing.
Tests with weak evidence behind them
Some tests offered by naturopathic and functional medicine practices aren't supported by mainstream guidance. They're often paid in cash, so it's worth knowing before you agree to them:
| Test | Often offered for | What the guidance says |
|---|---|---|
| Food-specific IgG blood panels | "Food sensitivities" | Allergy societies in Europe (EAACI, 2008) and Canada (CSACI, 2012) have advised against using food-specific IgG tests to diagnose food reactions. A 2022 scientific short from the Association for Diagnostics & Laboratory Medicine says food-specific IgG has not been shown to be valuable for diagnosing food allergy, and cites the 2014 US allergy practice parameter (AAAAI/ACAAI) among its sources. Positive results can occur in healthy people. |
| Saliva or blood "adrenal fatigue" tests | Tiredness, stress | The Endocrine Society says there's no scientific proof adrenal fatigue is a medical condition, and no test can detect it (updated January 2022). |
| Reverse T3 | Thyroid symptoms | Rated not useful for routine thyroid testing in ADLM's lab-use guide, which names TSH as the main screen. |
| Urine organic acid panels | Nutrient status, metabolism, gut | Urine organic acid tests have been validated for diagnosing inherited metabolic disorders (2016 quality-assurance study). We found no study validating commercial panels for general wellness assessment. Labcorp says its own urine organic acid test has not been cleared or approved by the FDA and may miss some disorders (Labcorp). |
| Saliva sex-hormone tests | Hormone symptoms | Saliva immunoassays for estradiol and progesterone have performed poorly in validation studies, and were less valid than for testosterone (Psychoneuroendocrinology, 2025; a 2022 study found the same). |
| "Provoked" urine heavy-metal tests (after a chelating drug) | Suspected metal toxicity | The American College of Medical Toxicology recommends against post-chelator challenge urine metal testing (ACMT, 2017), and no standard, validated challenge test exists (ACMT, 2013). |
For any test, ask what it's for, how the result would change the plan, and whether your primary care doctor would accept it. For more on the debate, see is functional medicine legit?
Tired all the time but blood work is normal
Before adding specialty tests, it helps to know how doctors decide which tests to run for fatigue.
How doctors choose tests for fatigue
A primary care evaluation starts with a history, a physical exam and a review of medicines. There's no single standard blood panel. A 2023 review in the American Academy of Family Physicians' journal says the first tests should follow from the history, the exam and the most likely causes. It adds that testing without a specific reason is low-yield, changing treatment in about 5% of patients (Latimer et al., American Family Physician, 2023).
Instead, the review lists tests by suspected cause. They include a complete blood count (CBC), ferritin and other iron tests, vitamin B12 and folate, A1C, TSH, a basic or comprehensive metabolic panel, urinalysis, and inflammation markers (CRP and ESR). Which ones make sense depends on the symptoms and exam. The NHS also lists blood tests for anemia, diabetes and thyroid problems when tiredness has no clear cause (NHS).
When to see a doctor about tiredness
- Tiredness lasts more than a few weeks with no clear cause, or affects daily life.
- It comes with weight loss or a change in mood.
- Someone notices snoring with gasping or choking during sleep, which can be a sign of sleep apnea.
- It comes with fever or night sweats. Mayo Clinic advises a visit when night sweats happen regularly, disrupt sleep, or come with fever or weight loss you didn't try for (Mayo Clinic).
The first three are the NHS's reasons for a non-urgent GP visit (NHS). If you have thoughts of harming yourself, call or text 988 to reach the 988 Suicide & Crisis Lifeline, free and open 24 hours a day, or call 911 if someone is in immediate danger (SAMHSA).
If the results come back normal
If standard results are normal and the tiredness continues, these steps can help you get more from the tests already done, and avoid paying for the same tests twice:
- Get copies of the results and the list of what was tested, with the dates. Ask for the actual values, such as ferritin and TSH, not just "normal."
- Ask the doctor what has been ruled out, what hasn't been checked, and whether anything should be repeated or followed up.
- Keep a short symptom log (sleep, energy, cycle, digestion, mood) and bring it to appointments.
- Before paying for more tests elsewhere, ask how each result would change the plan, and whether your doctor would accept it.
- Tell every provider about all tests and treatments, including supplements, so care can be coordinated (NCCIH).
Our page on fatigue when blood work is normal covers what the evidence shows for holistic options and lists practitioners to compare. For new, severe or worsening symptoms, see a medical doctor first.
What lab tests cost and who pays
- Price: we found no reliable published range for naturopath-ordered panels. As one example from a national functional medicine practice, Parsley Health estimates $200 to $500 for standard labs billed to insurance, and about $400 for each specialty test, which typically isn't covered (Parsley Health, checked October 2026). Ask for a written, itemized quote for each test before you agree to it.
- Insurance: coverage depends on your plan and the test. Ask whether the lab is in your plan's network and whether the ordering clinician is a provider your plan recognizes.
- HSA or FSA: laboratory fees that are part of medical care are a qualified medical expense (IRS Publication 502). See using an HSA or FSA for a naturopath.
- Avoid repeats: bring recent results from your primary care doctor so tests aren't run twice.
For visit prices and coverage, see how much a naturopath costs and what insurance covers.
Questions to ask before you agree to tests
- Are you licensed in this state, and does your license let you order lab tests?
- If not, which licensed clinician orders and reviews them?
- Which tests do you recommend, what does each cost, and which are optional?
- Can you use my recent results instead of repeating tests?
- Will you send the results to my primary care doctor?
- What will we do differently depending on the results?
What to do next
- Compare naturopathic doctors near you and check the license each one lists, or browse naturopathic doctors in New York.
- Read how to find and vet a naturopathic doctor.
- Comparing options? See functional medicine doctors and how a naturopath and a functional medicine doctor differ.
- Keep your primary care doctor in the loop, especially if a test result is abnormal.
Last reviewed: October 2026