Low Hanging Fruit: Addressing Nutrient Deficiencies in Functional Psychiatry

Nutrient deficiencies

By focusing on commonly overlooked deficiencies in zinc, vitamin D, iron, B12, folate, and omega-3 fatty acids, I have been able to implement straightforward, yet profoundly effective, interventions that have led to significant positive outcomes for my patients, regardless of their primary psychiatric diagnosis. While it can be easy to get caught up in the latest and greatest in functional testing, sometimes correcting nutrient deficiencies identified on simple blood work can help us avoid, or at least reduce, our use of more expensive laboratory assessments.

While the Diagnostic and Statistical Manual (DSM), sometimes referred to as the Bible of psychiatry, often indicates that psychiatric illness can only be diagnosed once medical causes have been ruled out, this initial step is often overlooked. I cannot tell you how many times a patient has said something along the lines of, “Huh? You want to test my blood? No psychiatrist has ever cared to do that!”

The essence of functional psychiatry is the understanding that psychiatric symptoms often have multifactorial origins. One of the key takeaways in the Psychiatry Redefined fellowship is the concept of “low hanging fruit” — simple, easily addressable factors that can make a significant difference in patient outcomes. Nutrient deficiencies are a prime example. Many patients struggling with psychiatric symptoms have diets that are insufficient in essential nutrients, and correcting these deficiencies can lead to remarkable improvements in their mental health and overall well-being.

Zinc

Zinc is a critical nutrient that often flies under the radar in conventional psychiatric practice. It plays a vital role in neurogenesis, synaptic function, and neurotransmitter regulation. Many patients with depression and anxiety have been found to have low levels of zinc. By routinely screening for and addressing zinc deficiency, I have seen improvements in mood stability, anxiety, and cognitive function in my patients. This simple intervention has made a notable difference, particularly for those who did not fully respond to traditional pharmacotherapy.

Vitamin D

Vitamin D deficiency is another common issue with profound implications for mental health. This vital nutrient, maybe more appropriately described as a hormone, is crucial for brain health, influencing the synthesis of neurotransmitters and neurotrophic factors.

Low levels of vitamin D have been linked to depression, seasonal affective disorder, and schizophrenia. Ensuring adequate vitamin D levels through supplementation or increased sun exposure has led to marked improvements in mood and energy levels in my patients. This has been especially beneficial for those with depressive symptoms during the winter months.

Iron

Iron deficiency, even in the absence of anemia, can significantly impact mental health. Iron is essential for the production of neurotransmitters like dopamine and serotonin. Patients with iron deficiency often present with fatigue, poor concentration, and depressive symptoms. By identifying and treating iron deficiency, I have observed enhanced cognitive function, increased energy, and a reduction in depressive symptoms, which has been particularly impactful for women of childbearing age who are more prone to iron deficiency.

Vitamin B12 and Folate

Vitamin B12 (methylcobalamin) and Vitamin B9 (folate) are critical for neurodevelopment and cognitive function. Deficiencies in these vitamins can lead to a range of psychiatric symptoms, including depression, cognitive impairment, and even psychosis. B12 deficiency is relatively common, especially in older adults and those with gastrointestinal issues. Folate deficiency is also prevalent in populations with poor dietary intake or certain genetic polymorphisms affecting folate metabolism. Addressing deficiencies in these vitamins has resulted in improved cognitive function, mood, and overall mental health in my patients.

Omega-3 Fatty Acids

Lastly, omega-3 fatty acids are vital for brain health, with anti-inflammatory properties and a role in cell membrane fluidity that supports neurotransmitter function. Many psychiatric disorders, including depression and bipolar disorder, have been associated

with low levels of omega-3s. By recommending therapeutic doses of high quality omega-3 supplements, I have seen improvements in mood regulation, decreased aggression, and better overall emotional stability in my patients. This intervention has been particularly beneficial for individuals with mood disorders who have not fully responded to medication.

Summary

The Psychiatry Redefined Fellowship has equipped me with the knowledge and tools to identify and address these nutrient deficiencies systematically. This approach has not only enhanced the therapeutic outcomes for my patients but has also fostered a more comprehensive understanding of their health. By integrating nutritional assessments and interventions into my psychiatric practice, I have been able to offer more personalized and effective care, ultimately improving the quality of life for my patients.

In conclusion, addressing nutrient deficiencies is a relatively simple yet profoundly impactful strategy in psychiatric care. Through the insights gained from the Psychiatry Redefined Fellowship, I have seen firsthand the significant positive outcomes that can be achieved by identifying and correcting deficiencies in zinc, vitamin D, iron, B12, folate, and omega-3s. This integrative approach has proven to be an invaluable addition to my practice, highlighting the importance of considering nutritional status in the comprehensive treatment of psychiatric patients.

In health,
Josh Habansky, MSN, PMHNP-BC