Integrative thyroid care at LA Integrative Psychiatry looks at your thyroid together with your mood, sleep, nutrition, and medications. It is for people who have thyroid symptoms, people already on thyroid medication who still do not feel well, and people whose psychiatric medications may affect the thyroid. Some people call this thyroid optimization. Knarik Oganesyan, DNP, FNP-C, PMHNP-BC, prescribes and manages thyroid medication and mental health care in one place. We accept most major insurance.
We start with a full visit to review your symptoms, health history, and medications. Lab testing may include TSH, free T4, free T3 when useful, and thyroid antibodies. We may also check things that can cause similar symptoms, such as vitamin B12, vitamin D, iron, and blood sugar. We explain every result in plain language.
When your thyroid is underactive, the standard treatment is levothyroxine. We adjust your dose based on your labs and how you feel, with repeat tests about 6 to 8 weeks after each change. Along with medication, we look at sleep, stress, nutrition, and exercise, since these also affect energy and mood. Any supplement is discussed with you first, including the risks and whether research supports it.
Thyroid hormone affects the brain. Low thyroid levels can cause symptoms that look like depression, and high levels can cause anxiety, poor sleep, and a racing heart. Some psychiatric medications, such as lithium, can lower thyroid function. In some cases of depression that has not improved with standard treatment, providers may add a thyroid hormone called T3 (liothyronine) to the treatment plan. Your provider will tell you if this may be a fit for you and explain the risks and benefits.
Knarik Oganesyan is board certified as both a family nurse practitioner (FNP-C) and a psychiatric mental health nurse practitioner (PMHNP-BC). This lets one provider manage your thyroid medication and your mental health care, and coordinate both. Learn more about our integrative psychiatry approach and medication management.
Your plan is based on your labs, symptoms, history, and goals. It may include thyroid medication, changes to other medications, lifestyle steps, therapy, or psychiatric medication. Timelines vary from person to person, and your provider reviews progress with you at each visit.
With your permission, we share results with your primary care doctor or endocrinologist. Thyroid nodules, thyroid cancer, an overactive thyroid, and thyroid care during pregnancy are best managed by an endocrinologist, and we refer you when needed.
It is a thyroid evaluation that looks beyond a single lab number. We review your full labs, symptoms, medications, sleep, nutrition, and stress, then treat with standard thyroid medication when needed, along with lifestyle and mental health care.
We can look into why. We check whether your dose fits your labs, whether something else may be causing your symptoms, such as low iron, poor sleep, or depression, and whether other medications are affecting your thyroid.
Yes. If you take lithium, we check your thyroid levels regularly and can treat an underactive thyroid while you stay on lithium, if that is the best plan for you.
We accept most major insurance plans. Coverage varies by plan, and we verify your benefits before your first visit.
If you have thyroid symptoms, or you are on thyroid medication and still do not feel like yourself, schedule online or call our office at (747) 777-7047 for the earliest available appointment.
Schedule your appointment online at a time that works for you.
