Dr. George Papanicolaou

People's sex lives are not over at age, you know, 50, 60 or 70. There are men that come to me wanting to have prescriptions for Viagra at age 70. And I always tell them, I'm not giving it to you unless I get a written note from your wife.

It's only getting better as time goes on, so why stop?

Yeah. So prior to Viagra, there were some fairly primitive approaches to it, like vacuum pumps and revascularization, because vascular issues, endothelial dysfunction is a key part of what causes erectile dysfunction.

Right, but that hardening of the arteries not only reduces blood flow, but there's this endothelial dysfunction and it's in the endothelial cells that nitrous oxide has its effect.

Endothelial cells are the cells that are lining the blood vessels that are inside the penis.

There's multiple reasons. But before we go on to that, I think probably is a good idea. Let me just review quickly because we're going to talk about nitrous oxide. We're going to talk about why Viagra works and other drugs like it. Essentially, what happens is that You have the release of nitrous oxide.

So you release the NO, and the NO has its action on the endothelial cells inside the blood vessels of the penis. It also acts on the corpus cavernosum muscles. And so you get this simultaneous relaxation of those muscles so blood can flow in. Those are the big muscles of the penis so that when they're full of blood, they actually start the erection and maintain the erection.

And then you have the small blood vessels Nitrous oxide acts on those at the same time and causes those to constrict. So the blood that flows into the cavernous muscles then stays there as these small veins constrict. And that basically starts the erection and maintains the erection. And what happens is, and that's called tumescence.

Then you have detumescence when after the ejaculation the penis relaxes. And that's when 5-phosphodiesterase breaks down the compound that was responsible for causing that relaxation and constriction. And when that compound breaks down, the small blood vessels relax and the penis relaxes and becomes flaccid. It's the 5-phosphate diesterase that gets inhibited by Viagra.

People's sex lives are not over at age, you know, 50, 60, or 70. There are men that come to me wanting to have prescriptions for Viagra at age 70. And I always tell them, I'm not giving it to you unless I get a written note from your wife.

So this is just a little lesson to everybody listening. That's how it works. Viagra blocks the 5-phosphodiesterase, allows this... So basically it increases blood flow and makes the erection stay longer. Because you don't get the breakdown of this thing called cyclic GMP. So that doesn't break down. That maintains the...

the constriction of the small blood vessels, you can maintain, actually obtain an erection and sustain an erection for a longer period of time.

But that's what's going on. And so then what can affect, what are the things that affect that? So metabolic syndrome. So when you're thinking about people with ED, See, all the blue pill does is fix that end problem. It fixes that, let's just make sure we get the erection and we maintain it. But there's reasons why we get there.

We get there because of stress and its impact on that very, very sensitive neurovascular problem. That neurovascular, and it's not a problem, that neurovascular symphony that has to occur for you to have your erection and ejaculation. So metabolic syndrome,

Which is prediabetes, which includes, you know, to make that diagnosis, you have to have obesity, dyslipidemia, which is just abnormal. Cholesterol. Cholesterol, triglycerides, HDLs. You have to have hypertension. And one of the things is insulin resistance. And so insulin resistance is connected to endothelial dysfunction.

When those endothelial cells aren't working, then the NO, the nitrous oxide, is not going to have an impact, and you're not going to be able to start that erection. So what do you treat? You can give the person Viagra, but since metabolic syndrome has so many other impacts on their overall health and their health span and lifespan, it'd be better to fix that.

You're worried about your erection, but you know what? You better be worried about your heart and your brain because they're the ones that are really the target of what's going on.

And that's one of the points I really hoped we'd make today, because as important as erections are, it's getting those root causes that impact your overall health, and then the cherry on top of the pie is great erections.

But... There's alcohol, there's alcohol. And one of the roles that alcohol plays is that when you're drinking alcohol, that itself is going to impact that endothelial function during the time of your use. And you're going to maybe, at night, not have an erection. Here's what happens. You can stop drinking and say, okay, that will fix it, but there's something that happened.

You're going to have a psychogenic response. It's called performance anxiety. And for some men, once they have a failure, it multiplies itself. They get performance anxiety and it becomes a psychogenic problem. And there's a vast majority of men who have erectile dysfunction actually have a performance anxiety or psychogenic cause.

So, revascularization is essentially, you're having, as we talked about, hardening of the arteries. And there's two ways that can be done. Just like you have angioplasty or stents placed in the heart, the same thing can be done for the penis. And that's one possibility.

Very interesting responses to the problem. And we're going to go through other possibilities. As you said, we're going to talk about stem cells and platelet-rich plasma. I always like to go back to the idea that, yeah, you can be revascularized, but why get there in the first place?

All of these things actually work. I mean, I've had patients of mine use a vacuum pump. I don't know how they do it. It works, doc. I love it. I've had people get penile implants. It works, doc. I love it. And they're pressing their testicle and they're getting their erection. And, you know, that's how the pump works.

You know, the pump is inside one testicle and you start pressing on it and it gives you your erection and it works. I've had men use the injections. They feel like 18 years old again. But they all have diabetes, hypertension, metabolic syndrome, and I can't get them to get to that underlying cause. So I almost sometimes want to not let them get their erections.

A lot of things do get better. Erections may or may not get better. Testosterone can definitely have an impact on erectile dysfunction. It impacts the 5-phosphodiesterase we talked about earlier, and it also can have an impact on nitric oxide. And that can result in improved erections. And you ask me, why do we see this drop-off in testosterone?

Well, there's this natural drop-off in testosterone as men age. So after the age of 30, you're losing about 1% per year And over time, that's going to drop you pretty low. But that's not going to do it all by itself.

Here's the older guys that don't have raging testosterone. Those are the guys that have sleep apnea, they drink too much alcohol, they have diabetes, they haven't learned how to manage their stress. Did I mention sleep apnea?

Yeah, I did. But that's a very important one. And so those are things that as you age, begin to impact your body's ability to make testosterone.

And the smaller your...

Absolutely.

Mark... It goes back to one of the books you wrote called Eat Fat, Get Thin. So now I'm going to tell you this. The name of the book can now be, the one that I'll write will be Eat Fat, Get Hard.

So, yes, fat, because fat actually, we've talked about this before, has cholesterol in it, cholesterol is not a bad guy, cholesterol is a really important foundational molecule for building hormones and one of them is testosterone. So eating good healthy fat is going to allow you to have that precursor molecule to maintain high levels of testosterone as long as you're doing everything else right.

sleeping well, managing stress, and limiting your alcohol use.

So what we do is we always started the gut because there's a very strong gut-brain connection. And if you have an imbalance of that 100 trillion bacteria in your gut called the microbiome, this very important bacteria have to be in balance because they're really good guys of that group make things for our brain. They're also engaged in modulating some of the things in our brain.

So they make our serotonin, 90% of it, up to 90% comes from the gut. Dopamine metabolism can be altered by bacteria in our gut. It can be altered by our immune function in the gut.

So that gut-brain connection is really important because if you have neuroinflammation, I mean, if you have gut inflammation where you have leaky gut that will trigger the immune system into an inflammatory state or even into a state where it's making antibodies against self-tissue, That is going to cause neuroinflammation. It's going to activate glial cells or microglial cells.

And microglial cells, when they're activated by these gut processes, are going to then result in producing cytokines, which are inflammatory. They can also be balanced out and be anti-inflammatory, but oftentimes when we have this disorder of the gut-brain connection, we're having microglial activation and inflammation.

And so we did a stool test, and we also tested Claire for leaky gut. And the leaky gut test that I use also measures histamine levels in the gut and the enzyme that breaks down histamine levels in the gut. And in her case, she had a mild imbalance of her bacteria, but she had an overgrowth of candida, which is a yeast or a fungus. probably from the fact that she was eating all that sugar.

So that lifestyle of nutrition does play an important role in creating inflammation in the gut. Because now you've allowed candida to grow. Candida is highly immunogenic, highly inflammatory, and will definitely trigger the immune response and neuroinflammation we just talked about. But she also had an imbalance where she did not have enough of that enzyme to break down histamine.

So there's a chance that she's having histamine levels that are too high. and she's eating high histamine foods. And what that means is histamine can actually cross the blood-brain barrier, and there's histamine receptors in the brain. And when that histamine interacts with those receptors, it creates excitation, agitation, and it will actually worsen your symptoms of ADHD. She had that as well.

Exactly. So if you eat high histamine foods, avocado, garlic, onions, citrus fruits, and the like, if you... In the audience, if you're listening, Google histamine foods, make a list of them, and see what happens when you eat them. A lot of people with ADHD say, I get worse. My brain just gets fogged out. I get irritable. I get agitated. So she had that going on.

So right there, if I just started working on that with her, and exposed her to nutrition, got her eating cleaner, healthier foods, stopped having to eat sugars, having more fiber, polyphenols, aged foods, Right there, she's going to begin to feel a huge improvement.

I put her on a candida protocol. We use antifungals. In her case, I used botanical antifungals. And I gave her a probiotic that... actually had the ability to limit histamines in the gut. I gave her an enzyme to use if she was going to eat high histamine foods, and I gave her some glutamine to help clear up and fix the leaky gut. So Candida Protocol,

leaky gut protocol, a little support to help her digest your oxygen.

So we then do a pretty big deep dive into your nutrition, neurotransmitter balance, mitochondrial assessment, and all your nutrients. It's usually in one big test. It can be called an oats test. Other companies have different names for it. But you're looking at- Organic acids. Organic acids that are products of metabolism.

And when we look at those, we can see, are those organic acids in the right balance? And if they're not, that's an indicator functionally that particular systems and pathways aren't working correctly. And then we combine that with the nutrient assessment. We combine that with the mitochondrial function, and we get a picture.

And so in Claire's picture, we found that she had an omega index, omega-3 index. It was very low. So that means the all-important essential fatty acids, the omega-3s, EPA and DHA, they're very important. for neuronal function. They're very important for getting neurons to fire correctly. She was very low in omega-3s.

And she was very low. And there are studies, particularly with ADHD patients and omega-3s, and doses of upward of four grams per day suggest that in a large number of people with ADHD, they actually start just increasing their omegas. They start to see a benefit. And you see a reduction in their distractibility and improvement in focus. And also self-regulation of mood.

So omega is very important. On top of that, she had a very low vitamin D. She was deficient. And vitamin D is very important. It's a pro-hormone. It plays a very important role in mood regulation. And also it's a potent anti-inflammatory itself. We needed to increase their vitamin D. She was low on magnesium.

Magnesium plays a role in about 300 different very important chemical reactions in the body, particularly in the brain. It's very important for methylation, which is a basic chemical process. that can turn on neurotransmitters or off neurotransmitters and be involved in their metabolism. And if you're low on magnesium, it's going to impact how dopamine is managed. And dopamine is critical in ADHD.

It is the molecule in your frontal lobe that's responsible for learning, cognition, executive function and planning, and mood regulation. So it's very important that magnesium be at an appropriate level. So we needed to correct that as well. And on that particular organic acids test, we look at metabolites of dopamine and norepinephrine. First, we're out of balance.

So now we had a lot of information. We had low magnesium. We have low omegas. And we have now this out of balance dopamine system. So now I'm really beginning to understand a lot here, what we need to do. We need to replace, we need to fix the gut. We need to give her the nutrients like the omegas, the vitamin D, the magnesium.

Now this dopamine balance becomes really very important because it's out of balance. And here is one of the things we do. You're definitely not going to be getting at your local doctor anytime soon. And that's the genetic testing that we do.

And again, Mark, as we've talked about this before, and you've said and written about and used this term, the issue with the brain isn't necessarily the brain, it's the body. And that's what we put into the body that trigger all of these systems or deprive these systems of what they need to function correctly. So that's what we're doing here. We're fixing the body.

We're helping it function the way it was designed to function.

Yeah, so this is one of my favorite things to do. I order it on all my patients, but I can't wait to get the results back when I see my ADHD patient because oftentimes the genetics line up almost... hand-in-glove with what they're experiencing in their day-to-day life in terms of concentration, focus, mood dysregulation, their inability to read social cues.

What we do is we look at these, what we call single nucleotide polymorphisms, or these, I call them gene blueprints. You have gene blueprints. Your genes are just blueprints for making proteins, most of which are enzymes. Some of them are structural proteins, but That's what these are. They're blueprints.

And when God made you, he opened up the file for enzyme X. And when he opens it, there's six different blueprints. We don't know which one he gives you until we look. So we found out, you know, it depends on what mood he was in that day. He may have gotten a really fast enzyme X, a really slow enzyme X. We don't know until we do this test.

So now I can find out there's enzymes that break down dopamine. In various parts of the brain, there's enzymes that are responsible for serotonin metabolism. So we look at those. And there can be patterns that can be associated or predispose somebody to a certain way of thinking or behaving or experiencing the world. In Claire's case, one of the blueprints I look at is called the COMT.

So that COMT blueprint is basically responsible for breaking down dopamine in the prefrontal cortex. Dopamine is critical because it is the neurotransmitter responsible, as I said before, for cognition, learning, focus, attention, planning, which you call executive function, and self-regulation of emotion.

It plays a big role, although there are other parts of the brain, newer transmitters that do that as well. In her case, her gene breaks down dopamine very slowly. So she's predisposed to having a high level of dopamine in her brain at baseline, which is actually a good thing. And then she has another gene, the MAO gene. It also breaks down dopamine. And that one was also working very slow.

The role of those when those are really high, actually at baseline, your superpower will be the ability to focus and hyper-focus. The problem is that those two are also involved in the stress response. And people with a CMT, what we call met-met or slow-active, slow-performer, They tend to be anxious. They tend more towards depression. And they tend towards having ADHD.

Homozygous PT is slow. So she's met-met. Met-met is slow. That's met-met is, yeah, met-met and AA are the same. And that's slow. And she's going to build up her dopamine. So I found that she had the slow form of the CMT gene. Dopamine, we think, is great to be at higher levels in the prefrontal cortex. And it is. But it's also part of the fight or flight process.

reflex and dopamine in particular patients like claire her dopamine receptors also were impacted and so the dopamine when she's in her if everything's good she can concentrate but very little things would set her off she if if you know she'd have a phone call Somebody's going to be late, or she overdrew her bank account, or she failed a test. That would disrupt her very quickly.

So welcome, George. Mark, it's always a pleasure. Thanks for having me. I am so excited to talk about attention deficit hyperactivity disorder with you today.

She'd go into fight or flight because her dopamine levels and her norepinephrine levels are already high. They're very close to spilling over. So it doesn't take much to throw her into an anxiety state, in a state where she can't focus and concentrate. So we're able to balance that out. And there are ways of doing that.

One of the important things is making sure her sleep patterns, her circadian rhythm was in place. So I worked with her to establish a good circadian rhythm, a good circadian pattern. I gave her sleep techniques and rituals, things to do to support circadian rhythm and lock it down all day long. Then we use some supplements that can be very helpful. One of them is called Bacopa Mineri.

So we're not exactly sure.

We're not exactly sure how this herb works in the brain, but we know some of the effects is to balance out the dopamine. And we think it does that by actually reducing some of the oxidative stress and inflammation and also increasing the number of neuronal connections and how quickly they can communicate. And so that seems to have an impact on dopamine levels and can balance that out.

And people feel the effect of, hey, I'm calmer. I feel better. And with her particular CMT, she also benefits from another supplement called SAMe. SAMe is a methylation supporting compound. And in people with her particular CMT gene, it can be very mood stabilizing. And it doesn't work for everybody, but in her case, she found the right dose, and the CME was very helpful in stabilizing her mood.

In fact, the Bocopa and the CME, she said, had a better effect on her brain than the stimulant.

Helping her clear that dopamine, helping her balance it out. Again, just, you know, love to make this point is it wasn't just me giving her the Bacopa and the SAMe. It really helped. But that was also in conjunction with her going to sleep at the same time, waking up in the morning at the same time, being more aware of her need for exercise. exercise was something she didn't do.

And that is the first prescription I write for any of my ADHD patients. If you look at the literature and exercise impact on ADHD, it is the best drug for the ADHD brain. So we improved those things, and that really balanced out her dopamine. We also did some mitochondrial testing. It showed up on her OATS test, but we do a very specific test called the mitoswap that actually

looks at the very detailed function of the mitochondria. The organ in the body that requires the most energy is the brain. Mitochondria are in all your cells. They're the energy-making factory inside your cell. And if they're not functioning correctly, they're not going to produce enough energy. Your cells won't work properly. And then if they're not working correctly and making the energy,

When they make energy, they produce an oxygen molecule that needs to be removed as water. If that's not happening, you have a buildup of oxygen. It's oxidative stress. That oxygen molecule is like a pinball inside your mitochondria, inside your cell. It can even damage your DNA.

We found with Claire that she had a mitochondrial dysfunction where her mitochondria were compensating for excessive oxidative stress. And again, that's something that we can really fix. In her DNA, which I did mention earlier, she did have some variations in the genes in oxidative pathways. So she wasn't very good at removing oxygen. So I gave her some antioxidants.

First off, I gave her a handout at all the antioxidants that she could eat, because I always want my patients to get most of everything they need from the food that they eat. And then I supported that with antioxidants. And in her case, I use alpha lipoic acid and glutathione.

And as you mentioned, it occurs in autism as well. It's actually a bigger deal in autism than it is in people with ADHD, but it occurs in both. There's a fair amount of crossover between ADHD and autism in the brain. Helping those mitochondria function better is always a key part of helping people with their ADHD. She did have some toxins.

She had some mold toxins, and she also had a slightly elevated mercury level. Both of them were mild, not enough that we decided not to make that a first-tier issue. We'd see how she responded to everything else.

We don't want to overwhelm her with too much, but that's why I chose the glutathione and the alpha lipoic acid for her antioxidants, because they're also both potent detoxification agents. Alpha lipoic acid can bind a lot, and glutathione is your master detoxifying compound, so it's I had those guys doing double duty, and we were managing her toxins.

I see every week, probably at least if I see 16 patients a week, two to three of them have ADHD, either as a primary diagnosis, the coming CD4, or it's something they've struggled with, haven't recognized it, or they have recognized it and never done anything about it.

But one of the things I wanted to mention, it's a mold, mycotoxins. And that's on everybody's mind for whatever reason, whether it's social media, whether it's the news, what it is. The parents saw mold mycotoxins. They were very concerned. Well, the mold-type mycotoxins are very minimally elevated, and they were okra toxin, zero alone. Those molds are extraordinarily common in foods.

And she was eating a lot of foods that are known to be high in mold, peanut butter being one of them. And so I did have them test their house with a kit that we recommend, and their house tested negative. So it's really important to know that there are toxins in our food, and mycotoxins are one of them.

But we also have glyphosate, which I measured in her, and it was on the lower average side, so not a major concern. Bisphenol is another toxin that we're going to get in our plastics. Just as an aside, I want to remind everybody, when I'm talking about nutrition, I'm talking about what you eat. You've got to filter your water. You've got to eat organically.

You have to have a detox plan in your life because we live in toxic soup. Our exposome is huge. So that was a little aside I wanted to make about how toxins can impact.

Yeah, this is a really cool test. This is a urine peptide test, and it basically, we're able to measure metabolites of milk proteins and the gluten protein that you find in grains. And there's not an immune response. It triggers an immune response, but it's not an immune response. It's how particular people, we find that people with ADHD, with autism, tend to do this more.

When they break down their milk protein and their gluten protein, they break them down into smaller peptides. These are smaller proteins. that are then going to be absorbed into the body, certain peptides will actually cross the blood-brain barrier. And when they do, they have an opiate-like impact on the brain that can impact and affect cognition, learning, focus.

If they've never recognized it, sometimes they're hearing about it for the first time in the office as I go through their case, identify it for them. Why are we having so many cases? Why is it occurring so much more? I do think in this case, there's just a lot more awareness. I do think that there's been...

You become more distractible because when these come into the brain and hit those receptors, that's the impact. So she had both peptides. She had casomorphins and gluteomorphins. So into the brain, they create inflammation. They get these receptors. And on top of that inflammation, they can alter your ability to cognate and make sense of the world around you. So simple fix.

And people are, you know, they're always intrigued by this particular test because we do another test to look for the immune response to gluten when we do the gut testing, and that's negative. But when I tell them they have to be gluten and dairy-free, they say, why? I say, because of this test. And sometimes it doesn't make a difference.

There are some people where even if we make them dairy-free and gluten-free, they're not noticing any difference when they add those foods back in in regards to, oh, now they've been off them for six weeks. I'm adding them back in. I don't notice any difference. Or they'll say, I added them back in, and boy, I had a really bad afternoon.

One thing with Claire, she had a lot of bullying when she was in middle school, elementary school and middle school. And she also had parents, lovely parents, But their parenting style was to use a lot of negative reinforcement. If you don't do this, then that's going to happen. If you do this, then that will happen. They were constantly telling her, if you don't, you won't.

And that's really, it's really terrible for a person with ADHD. She said to me at one point when I was talking to her alone that she was generally one or two negative comments away from tears. So she had a real trauma. She was bullied. It was really hard to get through school. There were times she didn't want to ever go back to school because it was just so hard socially and academically.

So there is a diagnosis patients or I tell them your anxiety and depression are actually sort of separate from your ADHD. They're really symptoms. And there's symptoms of your ADHD, but not directly. They're really symptoms of the trauma you experience from your ADHD.

increased screening, and I do think the new definitions of what ADHD are have broadened the diagnosis. So in this case, I do think that does play a role.

And so Claire would tell me if certain things happened in her life, if she didn't get invited to a party, if she didn't get a good grade, if somebody said something negative to her, she just starts spiraling her default web network. She'd start ruminating over all these negative things. And then when that happens, she has all this negative self-talk.

And when you start to go down that negative self-talk, ruminant pathway that's triggered from trauma, what happens? You go into fight or flight. And when you go into fight or flight, what gets turned off? Your prefrontal cortex.

Because when you're running from the lion, you don't have time to have a philosophical thought conversation with yourself of whether it's a good thing to kill the lion or not. You kill it, you got to get away from it. You can't reason. So your prefrontal cortex gets turned off.

I encourage her to seek out a trauma therapist and consider doing something called eye movement desensitization repolarization. which is a way of rewriting those voices, rewriting those pathways so that you're not constantly going into that fight or flight because she has a superpower. We know genetically, if we can keep her calm and get her out of her own way, she can concentrate.

She has the capacity. In the end with Claire, it was a pretty dramatic turnaround. I would say four months is pretty dramatic and what we found was is she had improved her sleep patterns she no longer was having that racing mind that she couldn't control i started she started to meditate she started to have a sleep ritual that helped turn off that racing thought the fault mode place

Much better energy during the day. And more importantly, she now had energy at the end of the day to do things she really enjoyed, which in and of itself started to bring her satisfaction, joy, and contentment. Sugar cravings gone. Mood stability no longer easily triggered. Depression and anxiety gone.

Yeah, we've talked about this before. We both agree that the diagnostic criteria don't account for 400%. But what's going on in our world today, there are some fundamental things about the brain that I think we all maybe need to be reminded of or maybe understand the brain in a different way.

Yeah. You know, Mark, the Ultra Wellness Center is the Ultra Hope Center. It's so important that people have hope. And people do come. They come with a high level of expectation and hope because they hear these stories. We've done these podcasts before. And they come. And they do get better. I was thrilled for Claire. And she did a great job. This can be overwhelming.

But she put her nose to the grind because if she had another superpower, here's the reason. She was out-resilient. She was tenacious. She's tenacious. And again, when you have ADHD, it's like the economy of, you know what? I can hyper-focus. On the other hand, I forget my keys. everywhere. I forget my shoes, but I can hyper-focus, get an enormous amount of work done.

I can get really passionate about something, right? But on the other hand, I can become very rigid. I can become very stuck in a way of thinking that the fault mode network gets you there. ADHD has all these great superpowers, but on the other edge of the sword, they can have a negative impact. And when you can help somebody move over and

create an environment for themselves that utilize all their superpowers, you're going to change their life. And my final piece of advice to Claire was, Claire,

And going back to the idea that there's this hunter-farmer theory, that our brains are really designed to pay attention to a lot of things, which just as a quick aside, I think that the designation attention deficit hyperactivity disorder is the wrong nomenclature. People with ADHD, like me, just pay attention to way too many things.

And it really comes down to being able to organize the information and being able to recall it and assimilate it very quickly. In some ways, we can do that really well. But the brain was really designed to be able to be fast screening, high energy, novelty seeking, creative. That's what you needed to do when you were hunting and gathering. You had to pay attention to everything.

And then we had the theory that in the tribal nomadic societies, telling stories, having vision, being able to rapidly adapt was highly valued. And so those folks that had that tendency were actually important and valuable. They had ADHD. But what happened when we started the Industrial Revolution and we had a lot of the titans of industry,

involved in the development of education at the turn of the century in the industrial age, we created a system that was focused, orderly, routine, and valued compliance. That is absolutely terrible for the ADHD brain. So then we start to have more and more kids involved in this one-size-fits-all educational system, and they can't fit into that system. They can't sit and get Right.

And so they get the it's mostly boys. We get very hyperactive and fidgety. And the school setting just wasn't right for them. So now you add to that. We live in a world with one peak for seven year on. It's your phone, it's your computer, it's text, it's X, it's Facebook, it's Instagram. You're constantly being distracted.

In some ways, an ADHD person could thrive in that environment, but in other ways, And this is a dichotomy of ADHD, something that through real strength also is a weakness and something that can be a disability. And that's where all of this input, this constant input, they can keep up with it. We can keep up with it. But then it's a matter of organizing it.

putting the brakes on the information, putting it into sections in our mental library to recall when we need them. And that gets really difficult. So we have historical evolutionary forces at play. The brain's really designed to be a hunter-gatherer. Then when we design educational systems to be a one-size-fits-all, look at a blackboard, no visuals, and drone on, very difficult.

We've talked about this before, so of course I agree with you on that. That's what we do here at the Ultra Wellness Center, and I agree 100%. The one point I did want to make in that regard was that the brain does have structures, and we have these networks that are really important, and they're disordered in the ADHD brain.

So if you have ADHD, or even if you don't and you're listening to this podcast, and you find yourself trying to get a task done, but you're daydreaming at the same time, you're sort of distracted with other thoughts while you're trying to focus on what you're doing, that's actually a problem. Because that daydreaming network called the default mode network can be turned off.

When you're doing a task, it should be your task-positive network that's fitting right into that. So it's a network, it's a system that gets turned on so you can just pay attention to what you're doing, and that's it. But in the ADHD brains, that toggle switch between daydreaming, egocentric, how's the world affecting me, how do I affect the world piece, that toggle switch doesn't turn it off.

And when you're trying to do a task, you can't keep it. from daydreaming a bit. So it makes what you're doing harder. You have to concentrate harder. You get your work done. You just have to work harder at it.

And I just wanted to make the point that the reason why these systems may be disordered include, why? Inflammation. Nutritional deficiencies, single nucleotide polymorphisms, there's variations in your genes that impact how your dopamine and your serotonin and your norepinephrine flow.

All of that gets disrupted when you have inflammation, when you have trauma, when you have nutritional deficits, 100% agree.

Yeah, this is a great case because I see a lot, not a lot, a disproportionate number of students. We're right outside of Boston, and I've had at least four or five students in the last two years that have been brought in by their parents because they're in their freshman year or sophomore year, and they're anxious and depressed. They're trying to figure out why. My kid's going to Harvard.

My kid's going to Boston College. Why are they suddenly struggling in school? Why are they suddenly anxious and depressed? And this is the case that will illustrate what goes on. Claire is a 20-year-old woman. And she came to me. She had been struggling with focus and emotional regulation, always feeling overwhelmed and stressed for years. It got worse when she went to college.

When she was a child, they thought she might have ADHD. But they decided not to pursue it. They finally did. She was put on a medication. She felt terrible on it. Stimulants, like Adderall or Ritalin. She was put on Adderall, and she did not like it, so she never used it. Through school, she happens to be very bright, but she really struggled. And at times, she got bullied.

She got bullied through elementary school, middle school, and she was oftentimes called dumb and slow and And she wasn't any of those things. She just had a really hard time focusing. Organizing was very difficult for her. And she created systems, but she had to work really hard at them. And she felt overwhelmed all the time. But there was a very high standard set for her. So she didn't complain.

She put her nose down and she worked at it. And one of the things that parents commented to me was, he's always fatigued. He's always tired. Well, if you had to work as hard as she did, you're going to be tired at the end of your day. And it's going to be even harder to focus when you try to get your work done. So she struggled through these things. And she also struggled with sleep.

Mine was always racing, hard time falling asleep. She would wake up in the middle of the night, oftentimes catastrophizing. And she also would find herself drawn to eating lots of carbohydrates and sugars. He found them stimulating and helpful during the day, and she was drinking more coffee than she should.

It creates the neuroinflammation. It creates the nutritional deficits. When you're not getting those things that you need, you're just compounding the problem. So she's just pouring gasoline onto the fire. Typically in conventional medicine, this is what happens. She, parents take her to her local physician before they come to see me.

And he wants to put her on an antidepressant and even told her to consider taking a stimulant again. And they didn't want to do that. So they decided to bring her to the ultraviolet center to see me. We're going to now take the functional medicine approach that we're going to dig. We're going to dive deep and we're going to do what we do.

We're going to look for the clues in those root causes, those deep dive insights. conditions, and we have all the tools to do that. One, I've seen thousands in my career of patients with ADHD, so I know what to look for. I know what questions to ask to find out about lifestyle, because it all starts with lifestyle. You've got to get lifestyle under control. What does that mean?

That means you've got to be sleeping. You've got to be exercising. You've got to be eating correctly. You have to manage your stress well. And you have to make sure you have good, solid connections and relationship with people. It's very important for people with ADHD. Those connections are very important.