NUTRITIONAL PSYCHIATRY

Nutritional psychiatry is the study and clinical application of how diet, nutrient status and metabolic health affect mental illness — and how psychiatric medication affects them in turn. It is not an alternative to medication. It is the part of psychiatric care that most practices skip because rarely is anyone on staff trained in it.

What makes this practice different?

PA Erin Colvard is both a nationally certified (NCCPA) physician associate and a registered dietitian. She practiced clinical dietetics for thirteen years before completing PA school and specializing in psychiatry. That combination is rare. Most psychiatric practices that address nutrition refer out to a dietitian who cannot prescribe, or offer supplement advice from someone without formal nutrition training. Here, the same clinician who manages your medication has thirteen years of clinical dietetics behind them — which means the nutritional and pharmacologic sides of your treatment are decided together rather than in separate offices.

What does nutritional psychiatry actually involve?

In practice it means the following are part of your psychiatric care rather than an afterthought:

• Nutrient status — vitamin D, B vitamins (B1, B6, B12), folate (B9), iron and ferritin, magnesium, omega-3 fatty acids. Deficiencies in several of these produce symptoms indistinguishable from depression or anxiety, and are simple to identify and correct.
• Blood sugar stability — reactive hypoglycaemia produces irritability, anxiety and poor concentration that is frequently treated as a psychiatric symptom.
• Medication-related metabolic effects — weight gain, lipid changes and insulin resistance associated with several classes of psychotropic medication.
• Nutraceuticals, vitamins, minerals and amino acids — used where there is reasonable evidence, alongside conventional medication rather than instead of it.
• Dietary pattern — the overall pattern matters more than any single food or supplement.

Is there real evidence for this?

Some of it is well supported, some is promising but preliminary, and some is marketing. We think being clear about which is which is more useful than enthusiasm. What is reasonably well supported is that correcting documented nutrient deficiencies improves symptoms. Omega-3 supplementation has a modest but replicated effect in depression (both unipolar and bipolar). Overall dietary pattern is associated with depression risk in large observational studies. Metabolic side effects of psychotropic medication are real, measurable and worth managing.

Less established: most single-nutrient “mental health” supplements sold direct to consumers, elimination diets for psychiatric symptoms without a documented reason, and the more expansive claims made for the gut microbiome.

We will tell you which category something falls into. If a supplement has thin evidence and costs a significant amount every month, you deserve to know that before buying it.

Does this replace medication?

No. Nutritional psychiatry is integrative, not alternative. For moderate to severe psychiatric illness, medication and therapy remain the treatments with the strongest evidence, and we prescribe accordingly.

What nutritional work adds is a set of contributing factors that otherwise go unexamined — and in some patients those factors are why treatment has not worked as well as it should.

Who benefits most from this approach?

• People whose depression or anxiety has responded incompletely to medication
• People who have gained significant weight on psychiatric medication
• People with a history of disordered eating who need psychiatric care from someone who understands both sides
• People with gastrointestinal conditions affecting nutrient absorption
• People who want to understand what nutritional changes are actually worth making

How does this work with telehealth?

In fact, much of nutritional psychiatry is history-taking, dietary review and planning, all of which work as effectively by video. Lab work can be ordered locally wherever you are in Arizona. See our telehealth page for how virtual care works.

Related: obesity psychiatry for metabolic and weight concerns, and ADHD evaluation, where nutritional factors are frequently overlooked.

Treatment in person and throughout Arizona

We see patients in person at our office in Glendale (in the Arrowhead area) and via telehealth anywhere in Arizona — from Tucson, to Flagstaff, to the east valley, and everywhere between. Virtual visits are the same appointment with the same provider at the same rate.

Getting Started

Our comprehensive, new patient evaluations are $375 and require 60 to 90 minutes.

Our psychiatric follow-up visits are $125 and require 30 minutes.

(Thank you for arriving early, as we are unable to see late patients and must reschedule if life gets in the way of you arriving on time.)

We are out-of-network with all insurance carriers but will gladly provide a superbill you can submit to insurance to seek reimbursement.

For more info, please see our fees page.

Pinnacle Psychiatry

17505 N 79th Ave, Suite 309, Glendale, AZ 85308
Phone 623.321.2221 · Text 877.749.7502
Monday–Wednesday 8:00am–5:00pm · Thursday 7:00am–5:00pm