Although we can measure serotonin in peripheral blood, it may not reflect its activity in the central nervous system. Pupil dilation may serve as a marker for noradrenaline changes, but I can't think about one for serotonin. Is there a peripheral marker for changes in serotonergic drive?
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It depends on what you define as physiological, serotonin produce effects mainly in CNS influencing mood, sleep, etc. For what I know on PNS mainly acethilcoline and noradrenaline are the major neurotransmitters that produce visible markers.
One possibility for serotonergic pathway is to study circadian rhythm. But someone may explain better.
Consider the Serotonin syndrome
and do not forget the utility of platelets.
As you say plasma serotonin levels do not give information on the "serotergic" tone in the CNS; hence, no marker yet.
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