Symptom · Joint pain and stiffness
Most joint pain is wear, injury or age, and no blood test changes that. The blood test matters for the minority that is not: inflammatory arthritis, which is treatable and does permanent damage if it waits; gout, which is measurable and fixable; autoimmune disease, which takes an average of four years to diagnose in the UK; and the three things that cause widespread aching and get called "just joints" for years, which are an underactive thyroid, a low vitamin D and coeliac disease. A panel separates these in one draw, and the result decides whether you need a rheumatologist, a prescription, a supplement or a physiotherapist.
Venous draw at 103 UK clinics or at home. Report within 4 working days of your blood draw. No GP referral.
Last reviewed 16 September 2026
The short answer
A blood test for joint pain should cover hs-CRP for inflammation, urate for gout, a full thyroid panel, vitamin D, iron studies (for iron overload, which causes arthritis in the knuckles), and, if the pattern suggests it, the autoimmune markers: rheumatoid factor, anti-CCP, ANA and a coeliac screen. The single most useful thing it does is answer one question fast: is this inflammatory or mechanical? Inflammatory joint pain (worse in the morning, better with movement, swelling, more than an hour of stiffness) with a raised hs-CRP needs a rheumatology referral within weeks, not months, and a blood result is what gets the referral.
Educational, not a substitute for a doctor. A single hot, red, swollen joint with fever is a possible joint infection and an emergency: A&E or 999, not a blood panel.
What to test
| Marker | What it points to | What to look for | What happens next | Panel |
|---|---|---|---|---|
| hs-CRP | Inflammation of any cause: inflammatory arthritis, gout flare, infection, or the low-grade inflammation behind widespread aching | Above 3 mg/L with joint symptoms is worth pursuing; above 10 with swelling points to active inflammatory disease | Raised with morning stiffness and swelling: GP referral to rheumatology | All panels |
| Urate (uric acid) | Gout: sudden, severe pain in one joint, classically the big toe, ankle or knee, often at night | Above 360 µmol/L raises risk; above 420 with attacks is gout until proven otherwise. Can be normal during an attack, so test between them | Diet, alcohol, and for recurrent attacks allopurinol from your GP, which prevents them entirely | Ultimate and Signature |
| Thyroid (TSH, free T4, free T3, antibodies) | Underactive thyroid causes joint and muscle aches, stiffness, carpal tunnel and swelling that looks like arthritis | TSH above range or above 2.5 with symptoms; free T3 low; positive antibodies | Treatment resolves the joint symptoms; GP with the full panel in hand | All panels |
| Vitamin D | Deficiency causes deep bone and joint aching, muscle weakness and, when severe, osteomalacia | Below 30 nmol/L is deficient; below 50 insufficient | D3 at the right dose, retest in three months | All panels |
| Iron studies (ferritin, transferrin saturation) | Haemochromatosis, iron overload, causes arthritis in the second and third knuckles and is common in people of northern European descent | Transferrin saturation above 45% with a raised ferritin | GP for genetic testing; treated by venesection | All panels |
| Rheumatoid factor, anti-CCP, ANA | Rheumatoid arthritis (RF and anti-CCP), lupus and connective tissue disease (ANA); anti-CCP is the specific one | Positive anti-CCP with joint symptoms is strongly predictive of rheumatoid arthritis; a positive ANA needs interpreting with symptoms, as it is common in healthy people | Rheumatology referral; early treatment changes the outcome | Signature autoimmune profile |
| Coeliac screen (tTG-IgA) | Undiagnosed coeliac disease causes joint pain, fatigue and low iron and vitamin D; most UK cases are undiagnosed | Positive tTG while still eating gluten | GP for confirmation; a gluten-free diet resolves the joint symptoms | Signature digestive profile |
Thresholds are UK laboratory conventions and NICE guidance where it exists. Your report reads each result against the others. Guides: hs-CRP, thyroid, vitamin D, ferritin and iron studies, autoimmune blood tests.
Read it in context
Inflammatory
Small joints of the hands or feet, stiff for more than an hour on waking, better as the day goes on, sometimes both sides. hs-CRP raised. This needs a rheumatology referral quickly, and the blood result is what makes a GP act. If anti-CCP is positive, the case for urgency is stronger still.
Gout
Urate raised between attacks, often with a raised triglyceride and fasting insulin alongside, because gout travels with metabolic syndrome. Entirely preventable with treatment, and the panel shows the metabolic picture that drives it. Insulin resistance.
Widespread aching
hs-CRP normal, vitamin D at 22, TSH at 6, or coeliac screen positive. This is the picture behind years of "probably fibromyalgia" and it is the one most often missed, because none of the three is on a standard joint screen. Each is treatable.
Mechanical
Pain that is worse with use and better with rest, no swelling, no morning stiffness, clean bloods. This is osteoarthritis or injury, and a normal panel is the answer: it rules out the treatable mimics and points you to physiotherapy, load management and, where needed, imaging rather than more blood tests.
Which panel
Advanced
74 biomarkers · £269
hs-CRP, full thyroid with antibodies, vitamin D, full iron studies including transferrin saturation, liver, kidney, HbA1c. Covers inflammation, thyroid, vitamin D and iron overload.
View AdvancedInflammatory or not
Ultimate
140 biomarkers · £349
Adds urate for gout, fasting insulin and HOMA-IR (gout and metabolic syndrome travel together), cystatin C, the complete hormone set and tumour markers. The panel for joint pain with no obvious injury.
View UltimateSignature
230 biomarkers · £799
Processed by Randox. Adds the autoimmune profile (rheumatoid factor, anti-CCP, ANA) and the digestive profile including coeliac screening. The panel when the pattern is inflammatory, runs in the family, or has gone undiagnosed for years.
View SignatureClinic draw £19. At-home £39. Fast from 10pm the night before. For a coeliac screen, keep eating gluten until the test. Klarna and Clearpay available.
Honest comparison
If you have a swollen joint, more than an hour of morning stiffness, or symptoms in the small joints of both hands, go to your GP first. NICE says suspected inflammatory arthritis should be referred to rheumatology urgently, and a GP can run CRP, ESR, rheumatoid factor and anti-CCP and make that referral. That is the right route and it is free. Where a panel earns its place is the other, larger group: aching joints with nothing swollen, a GP screen that came back normal or was never run, and no explanation. The standard joint screen does not include vitamin D, a full thyroid panel with free T3 and antibodies, transferrin saturation, urate unless gout is suspected, or a coeliac screen unless gut symptoms are mentioned. Those are the markers behind most undiagnosed joint pain, and a panel reads them together. What to ask your GP for.
After your result
Inflammatory, metabolic, thyroid, nutritional, iron overload, autoimmune, or none of the above, with each marker explained against the others and reviewed by a clinician.
A raised hs-CRP with joint symptoms, a positive anti-CCP or a raised urate with attacks needs a prescriber and, for the first two, a rheumatologist. The report tells you which results to show them and why they matter.
Vitamin D is corrected with supplements; a thyroid result is treated by your GP; both take about twelve weeks to show in the joints, and the second report confirms it.
FAQs
hs-CRP for inflammation, urate for gout, a full thyroid panel, vitamin D, iron studies with transferrin saturation, and where the pattern suggests it, rheumatoid factor, anti-CCP, ANA and a coeliac screen. The first five are in the Ultimate panel; the autoimmune and coeliac markers are in Signature.
It can tell you whether the arthritis is inflammatory (rheumatoid, psoriatic, gout) or mechanical (osteoarthritis). Inflammatory arthritis raises hs-CRP and often shows specific antibodies; osteoarthritis does not show in blood at all. That distinction is the one that decides treatment.
It can strongly suggest it. A positive anti-CCP with joint symptoms is highly predictive, and a raised hs-CRP with morning stiffness in the small joints is the picture that should trigger urgent referral. The diagnosis itself is made by a rheumatologist with examination and imaging alongside the blood results.
Urate above 360 µmol/L raises the risk and above 420 with typical attacks is gout until proven otherwise. Urate can read normal during an attack, so the test is best taken between them. Gout is completely preventable with treatment, which is why knowing the level matters.
Yes, and this is the group most often helped. Widespread aching with no swelling is the classic presentation of low vitamin D, an underactive thyroid and undiagnosed coeliac disease, none of which is on a standard joint screen and all of which are treatable.
Yes for Ultimate and Signature, because fasting insulin and lipids are included: nothing but water from 10pm the night before. If you want a coeliac screen, keep eating gluten in the weeks before; the test only works while you are. Full preparation guide.
Advanced and Ultimate reports are delivered within 4 working days of your blood draw. Signature takes up to 12 working days from your appointment.
Seven joint markers in one venous draw, at 103 UK clinics or at home, with a report within 4 working days that says which kind of joint pain you have and who should see it next.
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