Dr. Shebani Sethi
👤 PersonPodcast Appearances
Coming up on this episode of The Dr. Hyman Show.
Coming up on this episode of The Dr. Hyman Show.
This is like miracle growth for your brain cells, increases neuroplasticity, neurogenesis, meaning the making of new brain cells and the connections between brain cells. Also bacteria can produce really important compound called short chain fatty acids. These are called postbiotics.
This is like miracle growth for your brain cells, increases neuroplasticity, neurogenesis, meaning the making of new brain cells and the connections between brain cells. Also bacteria can produce really important compound called short chain fatty acids. These are called postbiotics.
of these things are postbiotics right prebiotics fertilize good bacteria probiotics are the bacteria and postbiotics are the compounds produced by the bacteria that are bioactive molecules or metabolites that are produced by healthy gut bacteria and impact our bodies and brains now short chain fatty acids are one of the most important of these and why because they affect every level of our health regulating cancer metabolism inflammation and gut health but they also cross the blood brain barrier and they affect brain health by regulating neurotransmitter levels and they reduce
of these things are postbiotics right prebiotics fertilize good bacteria probiotics are the bacteria and postbiotics are the compounds produced by the bacteria that are bioactive molecules or metabolites that are produced by healthy gut bacteria and impact our bodies and brains now short chain fatty acids are one of the most important of these and why because they affect every level of our health regulating cancer metabolism inflammation and gut health but they also cross the blood brain barrier and they affect brain health by regulating neurotransmitter levels and they reduce
information, which again is at the root of all this mental health stuff. Are you feeling stressed, sluggish, or struggling with sleep? You might be low on magnesium, and trust me, it's a bigger deal than you think.
information, which again is at the root of all this mental health stuff. Are you feeling stressed, sluggish, or struggling with sleep? You might be low on magnesium, and trust me, it's a bigger deal than you think.
Most magnesium supplements miss the mark, but Magnesium Breakthrough by Bioptimizers gives you all seven essential forms in one capsule, so your body gets the full benefits, better energy, stress relief, and deep, restorative sleep. I take it every night, and it's a total game changer. Try it now with an exclusive discount. Go to bioptimizers.com slash hymen and use code HYMEN10.
Most magnesium supplements miss the mark, but Magnesium Breakthrough by Bioptimizers gives you all seven essential forms in one capsule, so your body gets the full benefits, better energy, stress relief, and deep, restorative sleep. I take it every night, and it's a total game changer. Try it now with an exclusive discount. Go to bioptimizers.com slash hymen and use code HYMEN10.
Now, from treating thousands of patients over the last 30 years, I've learned that depression is mostly not in your head. It's in your body. When I treat patients' gut issues, and this is something I just discovered almost by accident, their mental health would magically get better. But it wasn't magic. It was science. I just didn't understand at the time. It's not magic.
Now, from treating thousands of patients over the last 30 years, I've learned that depression is mostly not in your head. It's in your body. When I treat patients' gut issues, and this is something I just discovered almost by accident, their mental health would magically get better. But it wasn't magic. It was science. I just didn't understand at the time. It's not magic.
Your body will thank you.
Your body will thank you.
You might lose your job.
You might lose your job.
Gut dysfunction is not the only cause of our mental health crisis. There's a lot of things that are driving it, but it's a major factor that's often unaddressed. Now, when your gut is unhealthy, when it's inflamed, your brain is unhealthy and also inflamed. When we fix... the gut, then brain health, mood, memory, focus, and mental health all improve. Now, why is this important?
Gut dysfunction is not the only cause of our mental health crisis. There's a lot of things that are driving it, but it's a major factor that's often unaddressed. Now, when your gut is unhealthy, when it's inflamed, your brain is unhealthy and also inflamed. When we fix... the gut, then brain health, mood, memory, focus, and mental health all improve. Now, why is this important?
I wouldn't go to jail like Galileo, but you might lose your job.
I wouldn't go to jail like Galileo, but you might lose your job.
Amazing.
Amazing.
When I heard about what you're doing, I just said the happy dance. I was like, and I've been telling everybody, I'm like, wow, finally, somebody's getting it where it counts. That's awesome.
When I heard about what you're doing, I just said the happy dance. I was like, and I've been telling everybody, I'm like, wow, finally, somebody's getting it where it counts. That's awesome.
Mm-hmm. It's quite extraordinary. And I don't know if you're aware of this, but right at Harvard, there is Uma Nadu, who has a whole department of nutritional psychiatry talking about the microbiome and the brain. And there's another physician who's been on my podcast at Stanford. They have a
Mm-hmm. It's quite extraordinary. And I don't know if you're aware of this, but right at Harvard, there is Uma Nadu, who has a whole department of nutritional psychiatry talking about the microbiome and the brain. And there's another physician who's been on my podcast at Stanford. They have a
department of metabolic psychiatry so it's starting to happen and more and more psychiatrists are becoming aware of the data because there is data there's a lot of literature now that supports this notion so when i when i look at sort of the mitochondria it's really about you know metabolism and energy and and and
department of metabolic psychiatry so it's starting to happen and more and more psychiatrists are becoming aware of the data because there is data there's a lot of literature now that supports this notion so when i when i look at sort of the mitochondria it's really about you know metabolism and energy and and and
And so I'd like you to sort of unpack how that actually connects to psychiatric diseases. Because, you know, I first heard this concept when I talked to Martha Herbert, who is a neurologist, and I think she's also worked in psychiatry, I might be wrong. who was treating autism. And she was doing brain scans on these autistic kids.
And so I'd like you to sort of unpack how that actually connects to psychiatric diseases. Because, you know, I first heard this concept when I talked to Martha Herbert, who is a neurologist, and I think she's also worked in psychiatry, I might be wrong. who was treating autism. And she was doing brain scans on these autistic kids.
She saw their brains were swollen and inflamed on biopsies with these kids got killed on a car accident or something. And see these brains are just full of inflammatory cells and the immune cells, the white blood cells called the glia. And she also called what they have a metabolic encephalopathy. she said that autism is not a brain disorder, it's a systemic disorder that affects the brain.
She saw their brains were swollen and inflamed on biopsies with these kids got killed on a car accident or something. And see these brains are just full of inflammatory cells and the immune cells, the white blood cells called the glia. And she also called what they have a metabolic encephalopathy. she said that autism is not a brain disorder, it's a systemic disorder that affects the brain.
Inflammation is a huge driver of most of our mental health issues from depression, anxiety, autism, ADD, even things like Alzheimer's, schizophrenia, bipolar disease, all linked to inflammation of the brain. And where is this inflammation coming from? Obviously our diet, but also from our microbiome. And I learned this early in my medical practice.
Inflammation is a huge driver of most of our mental health issues from depression, anxiety, autism, ADD, even things like Alzheimer's, schizophrenia, bipolar disease, all linked to inflammation of the brain. And where is this inflammation coming from? Obviously our diet, but also from our microbiome. And I learned this early in my medical practice.
And that's what I hear you saying, that psychiatric illness, for the most part, is a systemic disorder that affects the brain. And the causes can be many. It could be your diet, it could be your microbiome. But I was with a gentleman this weekend whose family was a Hungarian Jew whose family was killed in the Holocaust. He says, I don't know, 150 members of my family were killed in the Holocaust.
And that's what I hear you saying, that psychiatric illness, for the most part, is a systemic disorder that affects the brain. And the causes can be many. It could be your diet, it could be your microbiome. But I was with a gentleman this weekend whose family was a Hungarian Jew whose family was killed in the Holocaust. He says, I don't know, 150 members of my family were killed in the Holocaust.
I don't know everybody's name. And I've lived in a constant state of trauma and stress my whole life. And, you know, I was like, wow, this is the epigenetics of this.
I don't know everybody's name. And I've lived in a constant state of trauma and stress my whole life. And, you know, I was like, wow, this is the epigenetics of this.
And Scientific American just came out with a paper, not a paper, but an article documenting some of the research in New York after 9-11 where they saw women who were pregnant when 9-11 happened, their children were incredibly affected by epigenetics.
And Scientific American just came out with a paper, not a paper, but an article documenting some of the research in New York after 9-11 where they saw women who were pregnant when 9-11 happened, their children were incredibly affected by epigenetics.
the stress and trauma that happened to the mothers when they were pregnant and was registered in gene expression patterns and epigenetics and in cortisol levels and cortisol receptor function. And I was like, wow, this data is really coming along in this. So there's a lot of things that can affect it.
the stress and trauma that happened to the mothers when they were pregnant and was registered in gene expression patterns and epigenetics and in cortisol levels and cortisol receptor function. And I was like, wow, this data is really coming along in this. So there's a lot of things that can affect it.
But often the psychiatric problems are so misdiagnosed and mistreated, honestly, and it creates so much suffering. And so what you're talking about is really a revolution.
But often the psychiatric problems are so misdiagnosed and mistreated, honestly, and it creates so much suffering. And so what you're talking about is really a revolution.
In fact, on one of my early books called The Ultra Mind Solution, a deep dive into the way the body affects the brain, including the gut and the microbiome. Now, conventional medicine views these two things as completely separate and unrelated. And typically, if you have GI symptoms, you go to the GI doctor, a gastroenterologist. And if you have mental health issues, you go to a psychiatrist.
In fact, on one of my early books called The Ultra Mind Solution, a deep dive into the way the body affects the brain, including the gut and the microbiome. Now, conventional medicine views these two things as completely separate and unrelated. And typically, if you have GI symptoms, you go to the GI doctor, a gastroenterologist. And if you have mental health issues, you go to a psychiatrist.
Yeah, it's so true because I was reflecting on a guest we had on a previous podcast who's a pediatric neurologist, trained at Harvard, Oxford. She works at University of San Diego now. And she did brain imaging, functional MRI imaging of the brain in autistic kids and found they had energy problems, that mitochondrial energy deficits were evident in the brain of autistic kids.
Yeah, it's so true because I was reflecting on a guest we had on a previous podcast who's a pediatric neurologist, trained at Harvard, Oxford. She works at University of San Diego now. And she did brain imaging, functional MRI imaging of the brain in autistic kids and found they had energy problems, that mitochondrial energy deficits were evident in the brain of autistic kids.
And that by giving them mitochondrial nutrients, basically the cofactors and helpers that actually help you turn food and oxygen into energy, like CoQ10, for example, or B vitamins, and just some really simple things that are very inexpensive, that these kids would literally get better from autism.
And that by giving them mitochondrial nutrients, basically the cofactors and helpers that actually help you turn food and oxygen into energy, like CoQ10, for example, or B vitamins, and just some really simple things that are very inexpensive, that these kids would literally get better from autism.
That's not to say that all autism is just caused by these nutrition deficients or mitochondrial issues, but it's one of the things that we see. So there's a lot of people coming at this from a lot of different areas. You're in the psychiatric lane, but you know, the neurological lane is seeing this too, and so is pretty much every other, the other issue.
That's not to say that all autism is just caused by these nutrition deficients or mitochondrial issues, but it's one of the things that we see. So there's a lot of people coming at this from a lot of different areas. You're in the psychiatric lane, but you know, the neurological lane is seeing this too, and so is pretty much every other, the other issue.
I mean, whether it's your weight or whether it's heart disease or diabetes or Alzheimer's or Parkinson's, so many diseases are really related to mitochondrial dysfunction. So it's great. It's really amazing. And I think that this is such a breakthrough. And I think, you know, there's, how besides the ketogenic diet are you approaching addressing mitochondrial function? Because for example,
I mean, whether it's your weight or whether it's heart disease or diabetes or Alzheimer's or Parkinson's, so many diseases are really related to mitochondrial dysfunction. So it's great. It's really amazing. And I think that this is such a breakthrough. And I think, you know, there's, how besides the ketogenic diet are you approaching addressing mitochondrial function? Because for example,
In autism, they're using these mitochondrial cocktails and supplements to help.
In autism, they're using these mitochondrial cocktails and supplements to help.
to help with balancing your mood. They prescribe different drugs for each condition instead of understanding the root cause and treating that. And then we're gonna talk about how this works, why it's important, what the science is, and some of my clinical case studies, which are quite compelling.
to help with balancing your mood. They prescribe different drugs for each condition instead of understanding the root cause and treating that. And then we're gonna talk about how this works, why it's important, what the science is, and some of my clinical case studies, which are quite compelling.
Now in functional medicine, we know the gut and the brain are intimately connected and that the health of one directly impacts the other. So you can't fix the brain without fixing the gut and you can't fix the gut without fixing the brain. So it's bi-directional. It's not mind, body, body, mind, body, mind, mind, body. It's both, right? When we do that,
Now in functional medicine, we know the gut and the brain are intimately connected and that the health of one directly impacts the other. So you can't fix the brain without fixing the gut and you can't fix the gut without fixing the brain. So it's bi-directional. It's not mind, body, body, mind, body, mind, mind, body. It's both, right? When we do that,
Or genetics or other things we may not even understand. Yes. Right? Yeah, it's so true. And I just remember being in my clinic, you know, looking at the patients I saw and seeing not really treating their psychiatric problems, but they would come in with autoimmune disease or digestive problems or arthritis or whatever, migraine. And I would just do what I did.
Or genetics or other things we may not even understand. Yes. Right? Yeah, it's so true. And I just remember being in my clinic, you know, looking at the patients I saw and seeing not really treating their psychiatric problems, but they would come in with autoimmune disease or digestive problems or arthritis or whatever, migraine. And I would just do what I did.
And they would get better from other stuff. Like you're saying, you were treating this guy's weight loss and his schizophrenia got better. And I was like, wow, I call myself the accidental psychiatrist. I never intended to figure this stuff out, but I could not ignore what was in front of me. And I had a patient with ADD once who was...
And they would get better from other stuff. Like you're saying, you were treating this guy's weight loss and his schizophrenia got better. And I was like, wow, I call myself the accidental psychiatrist. I never intended to figure this stuff out, but I could not ignore what was in front of me. And I had a patient with ADD once who was...
so severe and he had you know really terrible inflammatory symptoms as well asthma and allergies and gut issues and migraines and you know of course the doctor who was treating him the psychiatrist just treated add with the stimulant and ignored the other things because of course they're not related but i treated it i just cleaned up his diet i gave him some vitamins i cleaned up his gut i you know very simple things and the mother brought home his homework and we'll post in the show notes because it's pretty impressive
so severe and he had you know really terrible inflammatory symptoms as well asthma and allergies and gut issues and migraines and you know of course the doctor who was treating him the psychiatrist just treated add with the stimulant and ignored the other things because of course they're not related but i treated it i just cleaned up his diet i gave him some vitamins i cleaned up his gut i you know very simple things and the mother brought home his homework and we'll post in the show notes because it's pretty impressive
about his homework before and after two months just of changing these few things. And these kids often have what we call dysgraphia. They're handwriting. You can't read it. He's 12 years old. It looks like somebody who's got some kind of severe disorder with writing or something. I don't know. And it went from severe dysgraphia to perfect penmanship in two months. And I'm like,
about his homework before and after two months just of changing these few things. And these kids often have what we call dysgraphia. They're handwriting. You can't read it. He's 12 years old. It looks like somebody who's got some kind of severe disorder with writing or something. I don't know. And it went from severe dysgraphia to perfect penmanship in two months. And I'm like,
Holy crap, what is going on in the brain? How does it go from being chaotic and disorganized and asynchronous, to being completely coherent? And it was really a mind-blowing concept for me, and that's where it gave me the idea of the book. I don't know if you know this, Chris, but the origin of functional medicine was in psychiatry from Abraham Hoffer.
Holy crap, what is going on in the brain? How does it go from being chaotic and disorganized and asynchronous, to being completely coherent? And it was really a mind-blowing concept for me, and that's where it gave me the idea of the book. I don't know if you know this, Chris, but the origin of functional medicine was in psychiatry from Abraham Hoffer.
Yeah. So I'm going to tell you this quick story. I don't want to dive into some more of your work. I don't want to take too much of a sidetrack. But it's fascinating. Abraham Hoffer was a Canadian psychiatrist who treated schizophrenia. And he sort of somehow got the idea that there was some abnormal molecules going on in the brain and that it was related to some kind of nutrient problem.
Yeah. So I'm going to tell you this quick story. I don't want to dive into some more of your work. I don't want to take too much of a sidetrack. But it's fascinating. Abraham Hoffer was a Canadian psychiatrist who treated schizophrenia. And he sort of somehow got the idea that there was some abnormal molecules going on in the brain and that it was related to some kind of nutrient problem.
So he gave high dose of niacin and zinc and B6 and magnesium. And many of these patients would improve or get better. And so he began to write about this, talk about this, and then he was friends with Linus Pauling. And Linus Pauling is a two-time Nobel Prize winner.
So he gave high dose of niacin and zinc and B6 and magnesium. And many of these patients would improve or get better. And so he began to write about this, talk about this, and then he was friends with Linus Pauling. And Linus Pauling is a two-time Nobel Prize winner.
He discovered the structure of proteins and he almost discovered the – well, he kind of did discover the double helix of the DNA and he told his son about it. But then they went – his son went to London and hang out with Watson and Crick and they kind of took it. That's a whole other story. And then he wrote an article in Science magazine.
He discovered the structure of proteins and he almost discovered the – well, he kind of did discover the double helix of the DNA and he told his son about it. But then they went – his son went to London and hang out with Watson and Crick and they kind of took it. That's a whole other story. And then he wrote an article in Science magazine.
And I've done this in thousands of patients, and the studies back this up, and more and more data's coming out. Guys like Chris Palmer, Uma Naidoo, a psychiatrist from Stanford, and integrated psychiatrists, functional psychiatrists are all seeing this, and data is really exploding on this. When I wrote the book 15 years ago, there was data, but it was limited.
And I've done this in thousands of patients, and the studies back this up, and more and more data's coming out. Guys like Chris Palmer, Uma Naidoo, a psychiatrist from Stanford, and integrated psychiatrists, functional psychiatrists are all seeing this, and data is really exploding on this. When I wrote the book 15 years ago, there was data, but it was limited.
I mean, Science, which is a very prominent medical journal, which I don't know if you've actually seen. It's called Orthomolecular Psychiatry written by Linus Pauling. Have you seen that?
I mean, Science, which is a very prominent medical journal, which I don't know if you've actually seen. It's called Orthomolecular Psychiatry written by Linus Pauling. Have you seen that?
Yeah, well, that was the genesis of that. And essentially, the idea was that we could correct ortho means to straighten, and molecular means molecules, to straighten the molecules of the brain by using high doses of nutrients to move chemical reactions to their completion. Now, it was a very simple idea, and it was super complicated paper, very scientific, but it sort of started this process.
Yeah, well, that was the genesis of that. And essentially, the idea was that we could correct ortho means to straighten, and molecular means molecules, to straighten the molecules of the brain by using high doses of nutrients to move chemical reactions to their completion. Now, it was a very simple idea, and it was super complicated paper, very scientific, but it sort of started this process.
And then Jeffrey Bland, who was really the father of functional medicine, was a student of Linus Pauling's. And Linus Pauling was kind of thought of as a crackpot later in his life. I mean, I don't know if you're going to call anybody who won two Nobel Prizes a crackpot, but he was kind of dismissed for his ideas about vitamin C and everything.
And then Jeffrey Bland, who was really the father of functional medicine, was a student of Linus Pauling's. And Linus Pauling was kind of thought of as a crackpot later in his life. I mean, I don't know if you're going to call anybody who won two Nobel Prizes a crackpot, but he was kind of dismissed for his ideas about vitamin C and everything.
But he was onto something, and this is what we're seeing now. So I think your work is so important, and your ability to actually communicate this, to look at the science is so important. So talk about how we can think about some of the inflammation process in mental health and metabolic health and what we need to do to fix that.
But he was onto something, and this is what we're seeing now. So I think your work is so important, and your ability to actually communicate this, to look at the science is so important. So talk about how we can think about some of the inflammation process in mental health and metabolic health and what we need to do to fix that.
People are listening, well, I hear this, my mitochondria aren't working, inflammation's connected. How do I start to address that in myself?
People are listening, well, I hear this, my mitochondria aren't working, inflammation's connected. How do I start to address that in myself?
But I saw it, and I saw the kind of whispers in the wind let's say, the sort of tea leaves. And I was like, okay, this is really something. And when I started to do this with my patients and when we do this now, we see profound improvements in mood and obviously digestive health and all other areas of health. So gut is just linked to everything.
But I saw it, and I saw the kind of whispers in the wind let's say, the sort of tea leaves. And I was like, okay, this is really something. And when I started to do this with my patients and when we do this now, we see profound improvements in mood and obviously digestive health and all other areas of health. So gut is just linked to everything.
By the way, the brain has got the most mitochondria per cell of any organ in the body. So it's really important.
By the way, the brain has got the most mitochondria per cell of any organ in the body. So it's really important.
But you can do something about it when the baby's born and you can fix the baby afterwards.
But you can do something about it when the baby's born and you can fix the baby afterwards.
So fix the gut, fix the body, fix the gut, fix the brain. I know how powerful this is and how powerful functional medicine is for fixing depression because I also had it. myself. And it wasn't because of something that had to do with my psycho-emotional health, but my physical health. My brain literally broke one day in 1996. I felt like I had ADD, depression, and dementia all at once.
So fix the gut, fix the body, fix the gut, fix the brain. I know how powerful this is and how powerful functional medicine is for fixing depression because I also had it. myself. And it wasn't because of something that had to do with my psycho-emotional health, but my physical health. My brain literally broke one day in 1996. I felt like I had ADD, depression, and dementia all at once.
One of the best doorways to the mitochondria is... Exercise, right? It stimulates the growth of new mitochondria, improves the function of mitochondria. It's quite important. And it also cuts down inflammation and activates your antioxidant enzymes. It has so many benefits. And we know it's better that they quill into many drugs for depression if you just exercise regularly, vigorously, right?
One of the best doorways to the mitochondria is... Exercise, right? It stimulates the growth of new mitochondria, improves the function of mitochondria. It's quite important. And it also cuts down inflammation and activates your antioxidant enzymes. It has so many benefits. And we know it's better that they quill into many drugs for depression if you just exercise regularly, vigorously, right?
And we know that diet also plays a role. And one of the challenges, and I wonder how do you address this with your colleagues? Because this is something I've found even at Cleveland Clinic, working with some of the researchers, they're like, Well, we can't do everything at once. We can't do diet and exercise and supplements and sleep.
And we know that diet also plays a role. And one of the challenges, and I wonder how do you address this with your colleagues? Because this is something I've found even at Cleveland Clinic, working with some of the researchers, they're like, Well, we can't do everything at once. We can't do diet and exercise and supplements and sleep.
And I'm like, we can only do one thing at once because we don't know what's going to work. And I'm like, wait a minute. If you want to grow a nice garden, you don't just go, I'm going to give the water the plant water only, but no soil or sunlight. And then I'm going to give it sunlight, but no soil or water. It doesn't respect the laws of nature.
And I'm like, we can only do one thing at once because we don't know what's going to work. And I'm like, wait a minute. If you want to grow a nice garden, you don't just go, I'm going to give the water the plant water only, but no soil or sunlight. And then I'm going to give it sunlight, but no soil or water. It doesn't respect the laws of nature.
So how do you kind of battle that within the medical paradigm? Because it's really tough. We're looking for the single drug, for the single disease, or the single outcome, which is a model based on infection, which can work. But even then it's flawed because it depends on the biological terrain and why some people get sick and don't, or why some people die and don't. We see that with COVID.
So how do you kind of battle that within the medical paradigm? Because it's really tough. We're looking for the single drug, for the single disease, or the single outcome, which is a model based on infection, which can work. But even then it's flawed because it depends on the biological terrain and why some people get sick and don't, or why some people die and don't. We see that with COVID.
Not everybody gets sick
Not everybody gets sick
I saw lots of doctors, psychiatrists. No one could find the cause, although they wanted me to take Prozac for my symptoms. And no one could agree on the diagnosis. Some said I had depression. Others said I had chronic fatigue. And in fact, I did have chronic fatigue. And I started to de- dive into the literature.
I saw lots of doctors, psychiatrists. No one could find the cause, although they wanted me to take Prozac for my symptoms. And no one could agree on the diagnosis. Some said I had depression. Others said I had chronic fatigue. And in fact, I did have chronic fatigue. And I started to de- dive into the literature.
It's like autism, right?
It's like autism, right?
Did you know that over 75% of people are deficient in magnesium? That's a problem because magnesium is essential for over 600 functions in your body, including energy production, stress regulation, and deep sleep. But here's the catch. Not all magnesium is created equal.
Did you know that over 75% of people are deficient in magnesium? That's a problem because magnesium is essential for over 600 functions in your body, including energy production, stress regulation, and deep sleep. But here's the catch. Not all magnesium is created equal.
And I consulted with other doctors and scientists, people on the leading edge of medicine. And I started to do some experimentation. And when I came to understand that it wasn't just one thing that caused my brain to break, it was accumulation of a lot of things. Diet stuff, stress, environmental toxins like mercury was a big factor. My gut was just a mess. In fact, that's what happened.
And I consulted with other doctors and scientists, people on the leading edge of medicine. And I started to do some experimentation. And when I came to understand that it wasn't just one thing that caused my brain to break, it was accumulation of a lot of things. Diet stuff, stress, environmental toxins like mercury was a big factor. My gut was just a mess. In fact, that's what happened.
I had mercury underlying all this. And then one day I got some kind of gut infection up in Maine at a camp. And then boom, my gut was off. And it didn't get back on track for many years until I figured out how to fix it. And all that leads to inflammation. So rebalancing my gut microbiome, getting rid of the mercury. It was messing up my gut because mercury interferes with gut function.
I had mercury underlying all this. And then one day I got some kind of gut infection up in Maine at a camp. And then boom, my gut was off. And it didn't get back on track for many years until I figured out how to fix it. And all that leads to inflammation. So rebalancing my gut microbiome, getting rid of the mercury. It was messing up my gut because mercury interferes with gut function.
Yeah, you were talking earlier about this idea of comorbidities, which is a term we use in medicine to describe diseases that occur in the same patient. So if you have high blood pressure, diabetes, depression, reflux, we call these comorbidities. But we were talking earlier about how they may not really be unrelated, that in fact, they may be very connected.
Yeah, you were talking earlier about this idea of comorbidities, which is a term we use in medicine to describe diseases that occur in the same patient. So if you have high blood pressure, diabetes, depression, reflux, we call these comorbidities. But we were talking earlier about how they may not really be unrelated, that in fact, they may be very connected.
And it sounds like from your observations, you made the conclusion that maybe it wasn't a coincidence that the fact that people who were overweight or unhealthy also had mental health issues, maybe there was a relationship, nutritional deficiencies, metabolic issues. You talk a lot about insulin resistance.
And it sounds like from your observations, you made the conclusion that maybe it wasn't a coincidence that the fact that people who were overweight or unhealthy also had mental health issues, maybe there was a relationship, nutritional deficiencies, metabolic issues. You talk a lot about insulin resistance.
So how did you come to sort of understand that that was really going on, that the biology of that was something that was real?
So how did you come to sort of understand that that was really going on, that the biology of that was something that was real?
Which is incredible because when you look at the level of mental illness in society, it's one of the biggest causes of disability. And one of the biggest costs is depression and anxiety. And I remember when I was seeing patients early on, treating them for insulin resistance and prediabetes and other issues or gut issues or diabetes.
Which is incredible because when you look at the level of mental illness in society, it's one of the biggest causes of disability. And one of the biggest costs is depression and anxiety. And I remember when I was seeing patients early on, treating them for insulin resistance and prediabetes and other issues or gut issues or diabetes.
It was the key to getting my brain and health back. I also saw this with so many of my patients. I had a woman who had severe OCD. She wouldn't clean up her house for years because she didn't want to move things around on the floor. Looked at her health and her biology and try to see what was going on. And in functional medicine, we just take out the bad stuff, put in the good stuff.
It was the key to getting my brain and health back. I also saw this with so many of my patients. I had a woman who had severe OCD. She wouldn't clean up her house for years because she didn't want to move things around on the floor. Looked at her health and her biology and try to see what was going on. And in functional medicine, we just take out the bad stuff, put in the good stuff.
other factors that were going on related to autoimmune disease or inflammation, and we would get them healthy, they would sort of say, wait, you know, my depression went away. My anxiety went away. My panic attacks are gone. My bipolar disease is better. My ADD is better. And I'm like, well, how did that happen?
other factors that were going on related to autoimmune disease or inflammation, and we would get them healthy, they would sort of say, wait, you know, my depression went away. My anxiety went away. My panic attacks are gone. My bipolar disease is better. My ADD is better. And I'm like, well, how did that happen?
And then you begin to go down the rabbit hole and you begin to look at the biology of what's happening. And one of the, I think the greatest discoveries around mental health is that it's an inflammatory problem very often that the brain is inflamed, but the brain can't say, ouch, like you have a sore throat or, you know, a swollen ankle. It manifests as all these psychiatric symptoms.
And then you begin to go down the rabbit hole and you begin to look at the biology of what's happening. And one of the, I think the greatest discoveries around mental health is that it's an inflammatory problem very often that the brain is inflamed, but the brain can't say, ouch, like you have a sore throat or, you know, a swollen ankle. It manifests as all these psychiatric symptoms.
So I'd love to be sort of take us down the road of how inflammation is connected to mental illness and what the approaches that you're using to help correct that.
So I'd love to be sort of take us down the road of how inflammation is connected to mental illness and what the approaches that you're using to help correct that.
Wait, so your brain chemistry gets screwed up when you eat processed food and sugar, is what you're saying?
Wait, so your brain chemistry gets screwed up when you eat processed food and sugar, is what you're saying?
So I saw she had a lot of bad bugs in her gut, a lot of overgrowth of yeast, and I gave her basically an antibiotic and a fungal that was designed to kill those particular bugs. And literally overnight, her OCD went away and she was able to clean up her whole house after decades. I also had a little girl who was a sweet little girl, nine years old, but was a terror.
So I saw she had a lot of bad bugs in her gut, a lot of overgrowth of yeast, and I gave her basically an antibiotic and a fungal that was designed to kill those particular bugs. And literally overnight, her OCD went away and she was able to clean up her whole house after decades. I also had a little girl who was a sweet little girl, nine years old, but was a terror.
So what you're saying is people who are overweight and obese often are very malnourished and vitamin and nutrient deficient.
So what you're saying is people who are overweight and obese often are very malnourished and vitamin and nutrient deficient.
That's sort of a paradox, right?
That's sort of a paradox, right?
They're eating all this food. Why are they nutritionally deficient? But they're actually among the most malnourished.
They're eating all this food. Why are they nutritionally deficient? But they're actually among the most malnourished.
They're looking in all the wrong places for the nutrients. They're eating more and more food. And I think a study from Kevin Hall and others showed that if you let people eat as much as they want and you give them ultra-processed food versus whole foods, they'll eat about 500 calories more a day of ultra-processed food because they'll keep eating and they're hungry and they keep driving.
They're looking in all the wrong places for the nutrients. They're eating more and more food. And I think a study from Kevin Hall and others showed that if you let people eat as much as they want and you give them ultra-processed food versus whole foods, they'll eat about 500 calories more a day of ultra-processed food because they'll keep eating and they're hungry and they keep driving.
And you talk a lot about it in your work, about the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you... literally become addicted to these compounds and how that affects you.
And you talk a lot about it in your work, about the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you... literally become addicted to these compounds and how that affects you.
And it's more like a coffee filter. You know, it's a sip.
And it's more like a coffee filter. You know, it's a sip.
She would get kicked out of school all day, on the bus ride home, they'd have to stop the bus 10 times. She was terrorizing her little sister, tearing up pictures of the family, just kind of little nuts. I did testing and she didn't have any gut symptoms, but we found really high levels of bacterial overgrowth and bad bugs in her gut and yeast overgrowth.
She would get kicked out of school all day, on the bus ride home, they'd have to stop the bus 10 times. She was terrorizing her little sister, tearing up pictures of the family, just kind of little nuts. I did testing and she didn't have any gut symptoms, but we found really high levels of bacterial overgrowth and bad bugs in her gut and yeast overgrowth.
People go, it's like emotional eating. It's not really biological, true addiction. What you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure.
People go, it's like emotional eating. It's not really biological, true addiction. What you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure.
You downregulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. Yeah. And it's really this vicious cycle that people get into. And then they blame themselves and they feel guilty for doing it. And they think they just have no willpower. But you're saying it's much bigger than that.
You downregulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. Yeah. And it's really this vicious cycle that people get into. And then they blame themselves and they feel guilty for doing it. And they think they just have no willpower. But you're saying it's much bigger than that.
I call sugar a recreational drug. I've never heard anybody say it, but I always write down in my book, sugar is a recreational drug. It's like if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.
I call sugar a recreational drug. I've never heard anybody say it, but I always write down in my book, sugar is a recreational drug. It's like if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.
Yeah.
Yeah.
Yeah, cookies and toilet paper.
Yeah, cookies and toilet paper.
And again, I gave her an antibiotic, an antifungal, and literally overnight, she turned into this beautiful, sweet little girl. So that made me think, oh my God, there's a whole untapped world here that we're missing of how to help people who not only have physical health issues, but also have mental health issues. So today we're gonna dive deep into the gut-brain connection.
And again, I gave her an antibiotic, an antifungal, and literally overnight, she turned into this beautiful, sweet little girl. So that made me think, oh my God, there's a whole untapped world here that we're missing of how to help people who not only have physical health issues, but also have mental health issues. So today we're gonna dive deep into the gut-brain connection.
No. It wasn't a run on broccoli.
No. It wasn't a run on broccoli.
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And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am chief medical officer.
This podcast represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.
This podcast represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.
This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.
This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.
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It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.
We're gonna share some functional medicine tools that will help support your gut health and obviously your mood and mental health too. So what is this gut-brain connection exactly? Well, let's go into the science. The human brain contains approximately 100 billion neurons, brain cells. nerve cells, right? The gut also has a nervous system.
We're gonna share some functional medicine tools that will help support your gut health and obviously your mood and mental health too. So what is this gut-brain connection exactly? Well, let's go into the science. The human brain contains approximately 100 billion neurons, brain cells. nerve cells, right? The gut also has a nervous system.
It's called the second brain, also known as the enteric nervous system. Enteric just means gut, fancy medical word. And this contains, get this, 500 million neurons. So there's five times as many neurons in your gut as in your brain. Now there's a bi-directional highway between the brain brain and the gut brain. And this is called the vagus nerve.
It's called the second brain, also known as the enteric nervous system. Enteric just means gut, fancy medical word. And this contains, get this, 500 million neurons. So there's five times as many neurons in your gut as in your brain. Now there's a bi-directional highway between the brain brain and the gut brain. And this is called the vagus nerve.
And it links our enteric nervous system with our brain and their central nervous system. And it's sending and receiving signals all the time. So whatever's happening in your brain, mood, stress, emotions, impacts your gut function. And whatever's happening in your gut impacts your brain function, right? Mind-body, body-mind. We talk about this. I felt sick to my stomach. I have gut feelings.
And it links our enteric nervous system with our brain and their central nervous system. And it's sending and receiving signals all the time. So whatever's happening in your brain, mood, stress, emotions, impacts your gut function. And whatever's happening in your gut impacts your brain function, right? Mind-body, body-mind. We talk about this. I felt sick to my stomach. I have gut feelings.
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Maybe you're so nervous you had to run to the bathroom, right? This is the gut-brain connection at work. There was a study that looked at more than 1.2 million hospitalizations for irritable bowel and 4,000 hospitals.
Maybe you're so nervous you had to run to the bathroom, right? This is the gut-brain connection at work. There was a study that looked at more than 1.2 million hospitalizations for irritable bowel and 4,000 hospitals.
And people with IBS or irritable bowel syndrome had three times higher risk of anxiety, two times greater risk of depression, and then two times greater risk of suicide ideation, meaning they were thinking of suicide versus the general population. Now we used to think that anxiety caused IBS. But now we know it's the other way around and a little bidirectional. So think about that.
And people with IBS or irritable bowel syndrome had three times higher risk of anxiety, two times greater risk of depression, and then two times greater risk of suicide ideation, meaning they were thinking of suicide versus the general population. Now we used to think that anxiety caused IBS. But now we know it's the other way around and a little bidirectional. So think about that.
It's not really the stress or anxiety or mental health issues that's causing irritable bowel. It's the change in the microbiome and the irritation, inflammation to the gut lining and the enteric nervous system that feeds back to the brain. It creates an irritable brain. So irritable bowel leads to an irritable brain. So before we dive any deeper, let's define the features of this gut-brain axis.
It's not really the stress or anxiety or mental health issues that's causing irritable bowel. It's the change in the microbiome and the irritation, inflammation to the gut lining and the enteric nervous system that feeds back to the brain. It creates an irritable brain. So irritable bowel leads to an irritable brain. So before we dive any deeper, let's define the features of this gut-brain axis.
The gut, which basically we talked about, is the GI tract. It starts at your mouth and it goes to your anus. It includes esophagus, stomach, small intestine, large intestine, all the way down to the bottom. The vagus nerve is the longest nerve that comes from your brain called the cranial nerve.
The gut, which basically we talked about, is the GI tract. It starts at your mouth and it goes to your anus. It includes esophagus, stomach, small intestine, large intestine, all the way down to the bottom. The vagus nerve is the longest nerve that comes from your brain called the cranial nerve.
It travels through the brainstem to the gut and it connects the gut to the central nervous system and it goes through the entire higher GI tract. Think about it. You've got huge amounts of gut. If you, if you laid out your small intestine flat, it would be the surface area of a tennis court. And then there's your large intestine and then your esophagus. So all that is really important.
It travels through the brainstem to the gut and it connects the gut to the central nervous system and it goes through the entire higher GI tract. Think about it. You've got huge amounts of gut. If you, if you laid out your small intestine flat, it would be the surface area of a tennis court. And then there's your large intestine and then your esophagus. So all that is really important.
The vagus nerve connects to other things like your heart and lungs and so forth. But this vagus nerve is a really important part of your nervous system called the parasympathetic nervous system. This is the relaxation nervous system. It also is called the autonomic nervous system or automatic nervous system.
The vagus nerve connects to other things like your heart and lungs and so forth. But this vagus nerve is a really important part of your nervous system called the parasympathetic nervous system. This is the relaxation nervous system. It also is called the autonomic nervous system or automatic nervous system.
So it's not usually under our willful control, although we can regulate it through various practices. The yogis have been doing this for centuries. It regulates involuntary sensory and motor functions. You say, I'm going to move my arms. You move your arm, but you'll go, oh, I want to digest my food. Can you please digest the food in there? Can you please regulate my heart rate?
So it's not usually under our willful control, although we can regulate it through various practices. The yogis have been doing this for centuries. It regulates involuntary sensory and motor functions. You say, I'm going to move my arms. You move your arm, but you'll go, oh, I want to digest my food. Can you please digest the food in there? Can you please regulate my heart rate?
Can you control my blood pressure? You don't really think about it. These things happen automatically. A lot of this happens through this automatic system. There's a lot of signaling that happens through this nervous system. For example, it helps control appetite. And how does it do that? Through a peptide hormone called GLP-1, right? You might've heard about this. This is...
Can you control my blood pressure? You don't really think about it. These things happen automatically. A lot of this happens through this automatic system. There's a lot of signaling that happens through this nervous system. For example, it helps control appetite. And how does it do that? Through a peptide hormone called GLP-1, right? You might've heard about this. This is...
Ozempic, Rigobi, and so forth. Manjaro, these are drugs now, quote drugs, but they're not really drugs. They're just mimicking your body's own GLP-1 at a much higher concentration. This is also known as the satiety hormone. I mean, it makes you feel full, which is why people don't eat because they take this shot and they don't feel full.
Ozempic, Rigobi, and so forth. Manjaro, these are drugs now, quote drugs, but they're not really drugs. They're just mimicking your body's own GLP-1 at a much higher concentration. This is also known as the satiety hormone. I mean, it makes you feel full, which is why people don't eat because they take this shot and they don't feel full.
And this is also why people lose weight because they take this shot They feel full, they don't want to eat as much, and they lose weight. This is typically secreted in the lower part of the intestine, but it basically reduces your appetite and promotes satiety. And it sends a single via the vagus nerve. So this is really important, this drug, right? It's Ozempic.
And this is also why people lose weight because they take this shot They feel full, they don't want to eat as much, and they lose weight. This is typically secreted in the lower part of the intestine, but it basically reduces your appetite and promotes satiety. And it sends a single via the vagus nerve. So this is really important, this drug, right? It's Ozempic.
Right now, Bioptimizers is offering my listeners a special discount. Just go to bioptimizers.com slash hymen and use code HYMEN10 at checkout. Don't wait. Your body will thank you. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there is simply not enough time for me to do this at scale.
Right now, Bioptimizers is offering my listeners a special discount. Just go to bioptimizers.com slash hymen and use code HYMEN10 at checkout. Don't wait. Your body will thank you. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there is simply not enough time for me to do this at scale.
So this is something your body makes. Also, there's other hormones that are regulated called CCK or cholecystokinin, peptide YY, really important. And other compounds called short-chain fatty acids. We're going to talk about why they're important. But these are made by your gut and suppress appetite by making you feel full by activating the vagus nerve. And these are things that you can regulate.
So this is something your body makes. Also, there's other hormones that are regulated called CCK or cholecystokinin, peptide YY, really important. And other compounds called short-chain fatty acids. We're going to talk about why they're important. But these are made by your gut and suppress appetite by making you feel full by activating the vagus nerve. And these are things that you can regulate.
Leptin is another hormone produced in fat cells and in the gut. And it's also the feel-full hormone. There's many of these redundant pathways in your body. And it exerts its effects through the vagus nerve. This network, this gut brain, this second brain or enteric nervous system is a vast network of, like I said, almost 500 million neurons. It's embedded in the lining of the GI tract.
Leptin is another hormone produced in fat cells and in the gut. And it's also the feel-full hormone. There's many of these redundant pathways in your body. And it exerts its effects through the vagus nerve. This network, this gut brain, this second brain or enteric nervous system is a vast network of, like I said, almost 500 million neurons. It's embedded in the lining of the GI tract.
What's in them not only is nerve cells, but also hormonal cells, right? Enteroendocrine cells. And they're throughout the entire GI tract. And they're involved in sensing all sorts of signals, right? What nutrients you're taking in, taste, mechanical stimuli, fiber. They detect the microbes, what's going on in there. They help sense toxic compounds. So it's really a critical system.
What's in them not only is nerve cells, but also hormonal cells, right? Enteroendocrine cells. And they're throughout the entire GI tract. And they're involved in sensing all sorts of signals, right? What nutrients you're taking in, taste, mechanical stimuli, fiber. They detect the microbes, what's going on in there. They help sense toxic compounds. So it's really a critical system.
And as I mentioned, this is called the second brain. It operates independently, but also with the brain brain, right? The central nervous system by the vagus nerve, and it controls everything, right? Gut motility, right?
And as I mentioned, this is called the second brain. It operates independently, but also with the brain brain, right? The central nervous system by the vagus nerve, and it controls everything, right? Gut motility, right?
Whether you're constipated or have diarrhea, enzyme secretion, digesting your food, hormone release that regulates appetite, and then mention the full hormones or the hungry hormones like ghrelin. And it also affects blood flow that aids in digestion and absorbing nutrients. So it's super important. And the microbiome consists of about 100 trillion microbes, 5,000 different species.
Whether you're constipated or have diarrhea, enzyme secretion, digesting your food, hormone release that regulates appetite, and then mention the full hormones or the hungry hormones like ghrelin. And it also affects blood flow that aids in digestion and absorbing nutrients. So it's super important. And the microbiome consists of about 100 trillion microbes, 5,000 different species.
And you got about two pounds of poop in there of microbes in your GI tract. So what do these microbes do? Well, they help you digest your food. They produce vitamins. They regulate hormones. And they help you get rid of toxins. It interacts with your whole enteric nervous system and central nervous system. So the microbiome is a whole other thing that's involved, right?
And you got about two pounds of poop in there of microbes in your GI tract. So what do these microbes do? Well, they help you digest your food. They produce vitamins. They regulate hormones. And they help you get rid of toxins. It interacts with your whole enteric nervous system and central nervous system. So the microbiome is a whole other thing that's involved, right?
You don't just have your brain brain and your second brain. You have your microbiome brain, let's call it, right? It's really important. And it helps regulate everything in your body. And it regulates mood particularly a lot.
You don't just have your brain brain and your second brain. You have your microbiome brain, let's call it, right? It's really important. And it helps regulate everything in your body. And it regulates mood particularly a lot.
Now the composition of your gut microbiome, and I'm going into this because it's important to understand if you're going to understand what to do about fixing your gut and how this all works, because I want you to understand the importance of understanding your gut as it regulates, regulating your mood and brain health and pretty much everything else.
Now the composition of your gut microbiome, and I'm going into this because it's important to understand if you're going to understand what to do about fixing your gut and how this all works, because I want you to understand the importance of understanding your gut as it regulates, regulating your mood and brain health and pretty much everything else.
So the composition of your gut flora, it varies from person to person. It depends on their diet, right? So if you're a hunter gatherer, and eating meat or bison all the time, or if you're a vegan, all that changes based on what you're eating. It changes based on your lifestyle, stress, toxins, genetics, all regulate the microbiome.
So the composition of your gut flora, it varies from person to person. It depends on their diet, right? So if you're a hunter gatherer, and eating meat or bison all the time, or if you're a vegan, all that changes based on what you're eating. It changes based on your lifestyle, stress, toxins, genetics, all regulate the microbiome.
Now there's a large research project going on called the Human Microbiome Project. It helps map out the gut microbiome of individuals who are healthy and who who are sick to understand better their gut bacteria species. So what defines a healthy gut? What defines a sick gut? And how does that relate to different diseases?
Now there's a large research project going on called the Human Microbiome Project. It helps map out the gut microbiome of individuals who are healthy and who who are sick to understand better their gut bacteria species. So what defines a healthy gut? What defines a sick gut? And how does that relate to different diseases?
Now what's amazing also to me, this blew my mind when I learned about it, is it a third to a half of all the metabolites in your blood, All the thousands of molecules floating around your blood that regulate everything in your body are not human. They're from your gut microbiome.
Now what's amazing also to me, this blew my mind when I learned about it, is it a third to a half of all the metabolites in your blood, All the thousands of molecules floating around your blood that regulate everything in your body are not human. They're from your gut microbiome.
That's why I've been busy building several passion projects to help you. If you're looking for data about your biology, check out Function Health for real-time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive.
That's why I've been busy building several passion projects to help you. If you're looking for data about your biology, check out Function Health for real-time lab insights. And if you're in need of deepening your knowledge around your health journey, check out my membership community, the Hyman Hive.
In other words, these molecules produced from bacteria in the gut are absorbed and then impact your whole biology, including your brain and your mood. There's still a lot we don't know about what makes a healthy gut or a sick gut, but we know a lot. Now, your gut microbiome can produce healing metabolites that keep your gut and immune system healthy. Things like short-chain fatty acids.
In other words, these molecules produced from bacteria in the gut are absorbed and then impact your whole biology, including your brain and your mood. There's still a lot we don't know about what makes a healthy gut or a sick gut, but we know a lot. Now, your gut microbiome can produce healing metabolites that keep your gut and immune system healthy. Things like short-chain fatty acids.
We'll talk about those soon. Vitamins like B12, for example. Riboflavin made in your gut. Enzymes. Or it can produce harmful metabolites. So bad bugs produce bad stuff. Good bugs produce good stuff. And the bad metabolites from bad bugs can be things like cytokines. We've learned about from COVID, the cytokine storm. These are inflammatory messenger molecules of your immune system. Endotoxins.
We'll talk about those soon. Vitamins like B12, for example. Riboflavin made in your gut. Enzymes. Or it can produce harmful metabolites. So bad bugs produce bad stuff. Good bugs produce good stuff. And the bad metabolites from bad bugs can be things like cytokines. We've learned about from COVID, the cytokine storm. These are inflammatory messenger molecules of your immune system. Endotoxins.
literally poisons. We call these lipopolysaccharides. These are endotoxins, things that are toxic, produced by bacteria that can be absorbed across a leaky gut, cause you to be inflamed and create disease, including obesity and mental health issues and much more. So bad bugs make you inflamed and almost all issues related to mental health.
literally poisons. We call these lipopolysaccharides. These are endotoxins, things that are toxic, produced by bacteria that can be absorbed across a leaky gut, cause you to be inflamed and create disease, including obesity and mental health issues and much more. So bad bugs make you inflamed and almost all issues related to mental health.
And it's really important to understand almost all mental health issues and brain issues, whether it's Parkinson's, Alzheimer's, autism, ADD, depression, anxiety, bipolar disease, schizophrenia are all caused by inflammation in the brain. So if we fix the inflammation, we can fix many of these things. And we'll talk about how to do that soon. Now, what is this gut mood connection?
And it's really important to understand almost all mental health issues and brain issues, whether it's Parkinson's, Alzheimer's, autism, ADD, depression, anxiety, bipolar disease, schizophrenia are all caused by inflammation in the brain. So if we fix the inflammation, we can fix many of these things. And we'll talk about how to do that soon. Now, what is this gut mood connection?
We talked about, so what is the gut and what is the gut brain and the second brain and the first brain and the hormones? Okay, we talked about all that. So the gut microbiome actually influences brain health and function, and it impacts your mood, impacts your stress level.
We talked about, so what is the gut and what is the gut brain and the second brain and the first brain and the hormones? Okay, we talked about all that. So the gut microbiome actually influences brain health and function, and it impacts your mood, impacts your stress level.
So literally you can have stress molecules produced in your gut that are not because of something happening outside, but something happening inside. And it increases the risk of depression, mental illness via a complex network of things. nerve cells, endocrine cells, or hormone cells, immune pathways. It's the psychoneuroendocrine immune system, right? We talked about this a lot.
So literally you can have stress molecules produced in your gut that are not because of something happening outside, but something happening inside. And it increases the risk of depression, mental illness via a complex network of things. nerve cells, endocrine cells, or hormone cells, immune pathways. It's the psychoneuroendocrine immune system, right? We talked about this a lot.
It involves all sorts of activities like the transport of neurotransmitters, tabloids, cytokines, and certain species of gut bacteria are directly involved in the production of neurotransmitters affecting both the gut and the brain. Let's talk about some of them. So dopamine, for example, is best known for its role in reward pathways, pleasure, motivation.
It involves all sorts of activities like the transport of neurotransmitters, tabloids, cytokines, and certain species of gut bacteria are directly involved in the production of neurotransmitters affecting both the gut and the brain. Let's talk about some of them. So dopamine, for example, is best known for its role in reward pathways, pleasure, motivation.
For example, we know about Adderall or these... ADD drugs, they all stimulate dopamine pathways. Sugar does. All the addictive compounds we like too. So does altruism, by the way. By the way, there are certain bacteria that help increase dopamine. Things like lactobacillus plantarum, bacillus subtilis, bacillus cereus, and certain strains of E. coli that are beneficial. Pretty cool.
For example, we know about Adderall or these... ADD drugs, they all stimulate dopamine pathways. Sugar does. All the addictive compounds we like too. So does altruism, by the way. By the way, there are certain bacteria that help increase dopamine. Things like lactobacillus plantarum, bacillus subtilis, bacillus cereus, and certain strains of E. coli that are beneficial. Pretty cool.
And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at drhyman.com for a summary of my favorite and thoroughly tested products. We have a mental health crisis. Globally, 300 million people are suffering from anxiety. 280 million people are suffering from depression.
And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at drhyman.com for a summary of my favorite and thoroughly tested products. We have a mental health crisis. Globally, 300 million people are suffering from anxiety. 280 million people are suffering from depression.
What about serotonin? Another important neurotransmitter involved in mood. It's involved in regulating various physiological processes, including the secretions of your intestinal tract, peristalsis, motility, respiration, blood vessel regulation, behavior, mood. We know all about Prozac. That's how it works through inhibiting serotonin reuptake in the nerve cells in the brain, which
What about serotonin? Another important neurotransmitter involved in mood. It's involved in regulating various physiological processes, including the secretions of your intestinal tract, peristalsis, motility, respiration, blood vessel regulation, behavior, mood. We know all about Prozac. That's how it works through inhibiting serotonin reuptake in the nerve cells in the brain, which
makes you have more serotonin. Now, certain bacteria that are good can actually help improve the concentration of serotonin. And by the way, 90 to 95% of serotonin in the body is produced in the gut. But bacteria like Lactobacillus plantarum or Streptococcus thermophilus, which are healthy bacteria you can get through supplements or you can help
makes you have more serotonin. Now, certain bacteria that are good can actually help improve the concentration of serotonin. And by the way, 90 to 95% of serotonin in the body is produced in the gut. But bacteria like Lactobacillus plantarum or Streptococcus thermophilus, which are healthy bacteria you can get through supplements or you can help
help grow their diet, actually help with improving serotonin. What about GABA? This is the relaxation neurotransmitter. It's sort of the receptor upon which Valium and the Benzos work. So GABA is sort of a relaxation neurotransmitter and it helps reduce neuronal excitability, helps reduce anxiety and stress. sleep.
help grow their diet, actually help with improving serotonin. What about GABA? This is the relaxation neurotransmitter. It's sort of the receptor upon which Valium and the Benzos work. So GABA is sort of a relaxation neurotransmitter and it helps reduce neuronal excitability, helps reduce anxiety and stress. sleep.
And a lot of bacteria can help produce this in your gut, like bifidobacterium, lactobacillus plantarum, lactobacillus reuteri, lactobacillus rhamnosus, even things like acromantia. We talked about this a little with Darlene from Pendulum Therapeutics. She basically was growing acromantia in this big vat to be a probiotic.
And a lot of bacteria can help produce this in your gut, like bifidobacterium, lactobacillus plantarum, lactobacillus reuteri, lactobacillus rhamnosus, even things like acromantia. We talked about this a little with Darlene from Pendulum Therapeutics. She basically was growing acromantia in this big vat to be a probiotic.
And they started to analyze what was in one of the metabolites that the acromantia was producing. And they actually found a big spike and it turned out to be GABA. So this acromantia bacteria, which is so important for so many reasons and have many podcasts and things we've written about it I'll share it in the show notes. Acromantia actually produces GABA. So it's like a natural valium.
And they started to analyze what was in one of the metabolites that the acromantia was producing. And they actually found a big spike and it turned out to be GABA. So this acromantia bacteria, which is so important for so many reasons and have many podcasts and things we've written about it I'll share it in the show notes. Acromantia actually produces GABA. So it's like a natural valium.
Other bacteria can influence the levels of neurotransmitters by encoding genes for enzymes that produce neurotransmitters or directly impacting the synthesis of neurotransmitters or the breakdown of neurotransmitters. So the microbiome plays a huge role in all sorts of neurotransmitter function.
Other bacteria can influence the levels of neurotransmitters by encoding genes for enzymes that produce neurotransmitters or directly impacting the synthesis of neurotransmitters or the breakdown of neurotransmitters. So the microbiome plays a huge role in all sorts of neurotransmitter function.
For example, the conversion of neurotransmitter precursors like tryptophan you get from your diet into serotonin, which is the happy mood chemical. They're also involved in the production of a really important compound in the body called BDNF, BDNF means brain derived neurotrophic factor.
For example, the conversion of neurotransmitter precursors like tryptophan you get from your diet into serotonin, which is the happy mood chemical. They're also involved in the production of a really important compound in the body called BDNF, BDNF means brain derived neurotrophic factor.
Right. So the rates of obesity and binge eating and addictive-like eating are rising alongside the increasing dominance of ultra-processed foods in the modern food environment. And there are several mechanisms as to how this works, some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body.
Right. So the rates of obesity and binge eating and addictive-like eating are rising alongside the increasing dominance of ultra-processed foods in the modern food environment. And there are several mechanisms as to how this works, some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body.
And we used to learn in medical school that you have this blood brain barrier that nothing can get across it. But that's not, it's like the Berlin Wall. But in reality, it does leak, right? And there are things that do cross.
And we used to learn in medical school that you have this blood brain barrier that nothing can get across it. But that's not, it's like the Berlin Wall. But in reality, it does leak, right? And there are things that do cross.
Yeah, so ultra-processed food and sugar decrease our dopamine receptors and make us eat more compulsively. Much like addictive drugs, the highly processed foods, they trigger dopamine reward pathways and they invoke addictive-like behaviors, which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food.
Yeah, so ultra-processed food and sugar decrease our dopamine receptors and make us eat more compulsively. Much like addictive drugs, the highly processed foods, they trigger dopamine reward pathways and they invoke addictive-like behaviors, which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food.
continuing to eat these things despite knowing the adverse consequences to it, and repeated attempts to try to quit, right? I'm describing addiction here, basically, and the consumption of larger quantities over time than intended.
continuing to eat these things despite knowing the adverse consequences to it, and repeated attempts to try to quit, right? I'm describing addiction here, basically, and the consumption of larger quantities over time than intended.
It's So sugar is an addictive substance. It's not Just something we say it has a straightforward neurochemical basis in the brain just like any other drug and I think of sugar as a It's a recreational food. It's not a food that's essential for survival. We make sugar through the process of gluconeogenesis, through other foods that we consume. It's really about excess carbohydrates.
It's So sugar is an addictive substance. It's not Just something we say it has a straightforward neurochemical basis in the brain just like any other drug and I think of sugar as a It's a recreational food. It's not a food that's essential for survival. We make sugar through the process of gluconeogenesis, through other foods that we consume. It's really about excess carbohydrates.
Exactly, yeah. Actually, I would like to share a story about this. Just during the era of COVID, since we're in it, just to give context as to why I wrote about this and why I'm working on this as well and continuing to feel motivated to continue to do my work is The shelter-in-place order had come, you know, a couple months back for my county, and I'm in California. I live in Menlo Park.
Exactly, yeah. Actually, I would like to share a story about this. Just during the era of COVID, since we're in it, just to give context as to why I wrote about this and why I'm working on this as well and continuing to feel motivated to continue to do my work is The shelter-in-place order had come, you know, a couple months back for my county, and I'm in California. I live in Menlo Park.
When it was announced, my husband, he's an infectious disease physician at Stanford, and I'm a psychiatrist and a medicine physician, as you... mentioned, we both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store and we saw many people loading up their carts with Pop-Tarts, Hawaiian Punch, popcorn, anything ultra processed, basically.
When it was announced, my husband, he's an infectious disease physician at Stanford, and I'm a psychiatrist and a medicine physician, as you... mentioned, we both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store and we saw many people loading up their carts with Pop-Tarts, Hawaiian Punch, popcorn, anything ultra processed, basically.
And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the grocery store.
And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the grocery store.
And toilet paper, exactly. And there were still, you know, produce left in the store. It wasn't like they ran out of produce.
And toilet paper, exactly. And there were still, you know, produce left in the store. It wasn't like they ran out of produce.
No. Here I was at the checkout counter and I was thinking to myself, staring at the person's cart in front of me that was full of the recreational food, as I mentioned, the food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic. or helping their immune system and, if anything, weakening it.
No. Here I was at the checkout counter and I was thinking to myself, staring at the person's cart in front of me that was full of the recreational food, as I mentioned, the food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic. or helping their immune system and, if anything, weakening it.
And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to kind of get that public message out on this topic.
And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to kind of get that public message out on this topic.
Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have pre-diabetes and diabetes. And when I look up the statistics on this in our country, 44% of adults today in our country are either pre-diabetic or they have diabetes. And I wonder to myself, what is that doing to our brain?
Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have pre-diabetes and diabetes. And when I look up the statistics on this in our country, 44% of adults today in our country are either pre-diabetic or they have diabetes. And I wonder to myself, what is that doing to our brain?
We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain, right? And so, I'm happy to talk more about my research and patient care. But one thing that I felt I didn't completely answer before was kind of how these hormones affect the brain with the addictive piece.
We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain, right? And so, I'm happy to talk more about my research and patient care. But one thing that I felt I didn't completely answer before was kind of how these hormones affect the brain with the addictive piece.
Yeah. Yeah. So kind of going back to that, you know, so I was talking about the definition of addiction. And we know that hormones like insulin and leptin, which is the hormone that tells us we're full, it sends a signal to our brain, and ghrelin that tells us that we're hungry, these hormones modify natural and drug reward pathways in the brain. I mean, they have so many effects on the brain.
Yeah. Yeah. So kind of going back to that, you know, so I was talking about the definition of addiction. And we know that hormones like insulin and leptin, which is the hormone that tells us we're full, it sends a signal to our brain, and ghrelin that tells us that we're hungry, these hormones modify natural and drug reward pathways in the brain. I mean, they have so many effects on the brain.
Our hunger hormones go awry and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet. And they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease
Our hunger hormones go awry and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet. And they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease
these shifts that occur in our blood sugar and our hormone levels to kind of go back to the homeostatic state that our body and our brains were meant to be in. And so I treat the metabolic dysfunction and I look at how that improves both metabolic issues as well as psychiatric outcomes.
these shifts that occur in our blood sugar and our hormone levels to kind of go back to the homeostatic state that our body and our brains were meant to be in. And so I treat the metabolic dysfunction and I look at how that improves both metabolic issues as well as psychiatric outcomes.
So the field has come a long way. There's a lot of research that's been done on the biological piece and neuroscience and looking at obviously the serotonin hypothesis, but that's a hypothesis and an observation from like 30 years ago.
So the field has come a long way. There's a lot of research that's been done on the biological piece and neuroscience and looking at obviously the serotonin hypothesis, but that's a hypothesis and an observation from like 30 years ago.
And all of these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of why are these chemicals imbalanced. And so That's an important question that I and others are trying to study through research studies and clinical trials.
And all of these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of why are these chemicals imbalanced. And so That's an important question that I and others are trying to study through research studies and clinical trials.
And like you said, we know that although our medications are necessary and lifesaving for many, they have undesirable side effects that can worsen metabolic health. And while it's helping in one domain, it may in some people also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one-size-fits-all approach.
And like you said, we know that although our medications are necessary and lifesaving for many, they have undesirable side effects that can worsen metabolic health. And while it's helping in one domain, it may in some people also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one-size-fits-all approach.
Mental health conditions are varied. They're heterogeneous and they have different phenotypes or presentations. We don't have a single mutation. or a gene that we can point to, or a lesion. There's no smoking gun. It's a complex relationship of multiple genes and environment. And unfortunately, a metabolic assessment is not part of that routine care, and stigma certainly plays a role in this.
Mental health conditions are varied. They're heterogeneous and they have different phenotypes or presentations. We don't have a single mutation. or a gene that we can point to, or a lesion. There's no smoking gun. It's a complex relationship of multiple genes and environment. And unfortunately, a metabolic assessment is not part of that routine care, and stigma certainly plays a role in this.
Obesity is stigmatized, and so is mental health. education about nutrition and metabolism was lacking in medical education. Most psychiatrists recognize this relationship.
Obesity is stigmatized, and so is mental health. education about nutrition and metabolism was lacking in medical education. Most psychiatrists recognize this relationship.
They're starting to. They understand that there are side effects with psychotropic medications. I think they don't necessarily have the expertise to treat it or address it. They don't know necessarily what to do about it. But most psychiatrists that I speak with, and my department certainly has been very supportive of this idea,
They're starting to. They understand that there are side effects with psychotropic medications. I think they don't necessarily have the expertise to treat it or address it. They don't know necessarily what to do about it. But most psychiatrists that I speak with, and my department certainly has been very supportive of this idea,
And someone has to do the research and someone has to do the work to kind of move the field forward. And there's a growing body of other researchers working on this. And we hope that evidence-based research has to be done to kind of change the mainstream standard of care.
And someone has to do the research and someone has to do the work to kind of move the field forward. And there's a growing body of other researchers working on this. And we hope that evidence-based research has to be done to kind of change the mainstream standard of care.
I think that is changing. There's a complex relationship between metabolic dysfunction and nutrition, food, mental health. And I want to start off by saying that the idea of food as medicine is not a new concept in the field of nutritional psychiatry. It's really grown over the past few decades by several prominent psychiatrists and researchers.
I think that is changing. There's a complex relationship between metabolic dysfunction and nutrition, food, mental health. And I want to start off by saying that the idea of food as medicine is not a new concept in the field of nutritional psychiatry. It's really grown over the past few decades by several prominent psychiatrists and researchers.
However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome, or looking at the Mediterranean diet, for example, affecting depression symptoms?
However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome, or looking at the Mediterranean diet, for example, affecting depression symptoms?
And these are all very important questions, but what I thought was missing and why I named our clinic and our group's work metabolic psychiatry is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. If a majority of us are suffering from obesity, type 2 diabetes, insulin resistance, metabolic syndrome, What is that doing to our brain?
And these are all very important questions, but what I thought was missing and why I named our clinic and our group's work metabolic psychiatry is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. If a majority of us are suffering from obesity, type 2 diabetes, insulin resistance, metabolic syndrome, What is that doing to our brain?
We know that these diseases affect multiple things. Mental illness rates have increased over the past 20 years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation. That research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses
We know that these diseases affect multiple things. Mental illness rates have increased over the past 20 years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation. That research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses
and the mitochondria the energy powerhouses of ourselves are not functioning optimally causing changes in brain signaling itself and the thought is if we can target inflammation insulin resistance the abnormal blood sugar etc as a method to improve mental health symptoms then we can really improve our patients lives further and
and the mitochondria the energy powerhouses of ourselves are not functioning optimally causing changes in brain signaling itself and the thought is if we can target inflammation insulin resistance the abnormal blood sugar etc as a method to improve mental health symptoms then we can really improve our patients lives further and
Again, mental illness has many different causes, but even if we, you know, can 5 to 10% of people have an improvement in these symptoms with this method, then I think that would be a pretty significant improvement of the overall mental and physical health of our country.
Again, mental illness has many different causes, but even if we, you know, can 5 to 10% of people have an improvement in these symptoms with this method, then I think that would be a pretty significant improvement of the overall mental and physical health of our country.
Coming up on this episode of The Dr. Hyman Show.
This is like miracle growth for your brain cells, increases neuroplasticity, neurogenesis, meaning the making of new brain cells and the connections between brain cells. Also bacteria can produce really important compound called short chain fatty acids. These are called postbiotics.
of these things are postbiotics right prebiotics fertilize good bacteria probiotics are the bacteria and postbiotics are the compounds produced by the bacteria that are bioactive molecules or metabolites that are produced by healthy gut bacteria and impact our bodies and brains now short chain fatty acids are one of the most important of these and why because they affect every level of our health regulating cancer metabolism inflammation and gut health but they also cross the blood brain barrier and they affect brain health by regulating neurotransmitter levels and they reduce
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Now, from treating thousands of patients over the last 30 years, I've learned that depression is mostly not in your head. It's in your body. When I treat patients' gut issues, and this is something I just discovered almost by accident, their mental health would magically get better. But it wasn't magic. It was science. I just didn't understand at the time. It's not magic.
Your body will thank you.
You might lose your job.
Gut dysfunction is not the only cause of our mental health crisis. There's a lot of things that are driving it, but it's a major factor that's often unaddressed. Now, when your gut is unhealthy, when it's inflamed, your brain is unhealthy and also inflamed. When we fix... the gut, then brain health, mood, memory, focus, and mental health all improve. Now, why is this important?
I wouldn't go to jail like Galileo, but you might lose your job.
Amazing.
When I heard about what you're doing, I just said the happy dance. I was like, and I've been telling everybody, I'm like, wow, finally, somebody's getting it where it counts. That's awesome.
Mm-hmm. It's quite extraordinary. And I don't know if you're aware of this, but right at Harvard, there is Uma Nadu, who has a whole department of nutritional psychiatry talking about the microbiome and the brain. And there's another physician who's been on my podcast at Stanford. They have a
department of metabolic psychiatry so it's starting to happen and more and more psychiatrists are becoming aware of the data because there is data there's a lot of literature now that supports this notion so when i when i look at sort of the mitochondria it's really about you know metabolism and energy and and and
And so I'd like you to sort of unpack how that actually connects to psychiatric diseases. Because, you know, I first heard this concept when I talked to Martha Herbert, who is a neurologist, and I think she's also worked in psychiatry, I might be wrong. who was treating autism. And she was doing brain scans on these autistic kids.
She saw their brains were swollen and inflamed on biopsies with these kids got killed on a car accident or something. And see these brains are just full of inflammatory cells and the immune cells, the white blood cells called the glia. And she also called what they have a metabolic encephalopathy. she said that autism is not a brain disorder, it's a systemic disorder that affects the brain.
Inflammation is a huge driver of most of our mental health issues from depression, anxiety, autism, ADD, even things like Alzheimer's, schizophrenia, bipolar disease, all linked to inflammation of the brain. And where is this inflammation coming from? Obviously our diet, but also from our microbiome. And I learned this early in my medical practice.
And that's what I hear you saying, that psychiatric illness, for the most part, is a systemic disorder that affects the brain. And the causes can be many. It could be your diet, it could be your microbiome. But I was with a gentleman this weekend whose family was a Hungarian Jew whose family was killed in the Holocaust. He says, I don't know, 150 members of my family were killed in the Holocaust.
I don't know everybody's name. And I've lived in a constant state of trauma and stress my whole life. And, you know, I was like, wow, this is the epigenetics of this.
And Scientific American just came out with a paper, not a paper, but an article documenting some of the research in New York after 9-11 where they saw women who were pregnant when 9-11 happened, their children were incredibly affected by epigenetics.
the stress and trauma that happened to the mothers when they were pregnant and was registered in gene expression patterns and epigenetics and in cortisol levels and cortisol receptor function. And I was like, wow, this data is really coming along in this. So there's a lot of things that can affect it.
But often the psychiatric problems are so misdiagnosed and mistreated, honestly, and it creates so much suffering. And so what you're talking about is really a revolution.
In fact, on one of my early books called The Ultra Mind Solution, a deep dive into the way the body affects the brain, including the gut and the microbiome. Now, conventional medicine views these two things as completely separate and unrelated. And typically, if you have GI symptoms, you go to the GI doctor, a gastroenterologist. And if you have mental health issues, you go to a psychiatrist.
Yeah, it's so true because I was reflecting on a guest we had on a previous podcast who's a pediatric neurologist, trained at Harvard, Oxford. She works at University of San Diego now. And she did brain imaging, functional MRI imaging of the brain in autistic kids and found they had energy problems, that mitochondrial energy deficits were evident in the brain of autistic kids.
And that by giving them mitochondrial nutrients, basically the cofactors and helpers that actually help you turn food and oxygen into energy, like CoQ10, for example, or B vitamins, and just some really simple things that are very inexpensive, that these kids would literally get better from autism.
That's not to say that all autism is just caused by these nutrition deficients or mitochondrial issues, but it's one of the things that we see. So there's a lot of people coming at this from a lot of different areas. You're in the psychiatric lane, but you know, the neurological lane is seeing this too, and so is pretty much every other, the other issue.
I mean, whether it's your weight or whether it's heart disease or diabetes or Alzheimer's or Parkinson's, so many diseases are really related to mitochondrial dysfunction. So it's great. It's really amazing. And I think that this is such a breakthrough. And I think, you know, there's, how besides the ketogenic diet are you approaching addressing mitochondrial function? Because for example,
In autism, they're using these mitochondrial cocktails and supplements to help.
to help with balancing your mood. They prescribe different drugs for each condition instead of understanding the root cause and treating that. And then we're gonna talk about how this works, why it's important, what the science is, and some of my clinical case studies, which are quite compelling.
Now in functional medicine, we know the gut and the brain are intimately connected and that the health of one directly impacts the other. So you can't fix the brain without fixing the gut and you can't fix the gut without fixing the brain. So it's bi-directional. It's not mind, body, body, mind, body, mind, mind, body. It's both, right? When we do that,
Or genetics or other things we may not even understand. Yes. Right? Yeah, it's so true. And I just remember being in my clinic, you know, looking at the patients I saw and seeing not really treating their psychiatric problems, but they would come in with autoimmune disease or digestive problems or arthritis or whatever, migraine. And I would just do what I did.
And they would get better from other stuff. Like you're saying, you were treating this guy's weight loss and his schizophrenia got better. And I was like, wow, I call myself the accidental psychiatrist. I never intended to figure this stuff out, but I could not ignore what was in front of me. And I had a patient with ADD once who was...
so severe and he had you know really terrible inflammatory symptoms as well asthma and allergies and gut issues and migraines and you know of course the doctor who was treating him the psychiatrist just treated add with the stimulant and ignored the other things because of course they're not related but i treated it i just cleaned up his diet i gave him some vitamins i cleaned up his gut i you know very simple things and the mother brought home his homework and we'll post in the show notes because it's pretty impressive
about his homework before and after two months just of changing these few things. And these kids often have what we call dysgraphia. They're handwriting. You can't read it. He's 12 years old. It looks like somebody who's got some kind of severe disorder with writing or something. I don't know. And it went from severe dysgraphia to perfect penmanship in two months. And I'm like,
Holy crap, what is going on in the brain? How does it go from being chaotic and disorganized and asynchronous, to being completely coherent? And it was really a mind-blowing concept for me, and that's where it gave me the idea of the book. I don't know if you know this, Chris, but the origin of functional medicine was in psychiatry from Abraham Hoffer.
Yeah. So I'm going to tell you this quick story. I don't want to dive into some more of your work. I don't want to take too much of a sidetrack. But it's fascinating. Abraham Hoffer was a Canadian psychiatrist who treated schizophrenia. And he sort of somehow got the idea that there was some abnormal molecules going on in the brain and that it was related to some kind of nutrient problem.
So he gave high dose of niacin and zinc and B6 and magnesium. And many of these patients would improve or get better. And so he began to write about this, talk about this, and then he was friends with Linus Pauling. And Linus Pauling is a two-time Nobel Prize winner.
He discovered the structure of proteins and he almost discovered the – well, he kind of did discover the double helix of the DNA and he told his son about it. But then they went – his son went to London and hang out with Watson and Crick and they kind of took it. That's a whole other story. And then he wrote an article in Science magazine.
And I've done this in thousands of patients, and the studies back this up, and more and more data's coming out. Guys like Chris Palmer, Uma Naidoo, a psychiatrist from Stanford, and integrated psychiatrists, functional psychiatrists are all seeing this, and data is really exploding on this. When I wrote the book 15 years ago, there was data, but it was limited.
I mean, Science, which is a very prominent medical journal, which I don't know if you've actually seen. It's called Orthomolecular Psychiatry written by Linus Pauling. Have you seen that?
Yeah, well, that was the genesis of that. And essentially, the idea was that we could correct ortho means to straighten, and molecular means molecules, to straighten the molecules of the brain by using high doses of nutrients to move chemical reactions to their completion. Now, it was a very simple idea, and it was super complicated paper, very scientific, but it sort of started this process.
And then Jeffrey Bland, who was really the father of functional medicine, was a student of Linus Pauling's. And Linus Pauling was kind of thought of as a crackpot later in his life. I mean, I don't know if you're going to call anybody who won two Nobel Prizes a crackpot, but he was kind of dismissed for his ideas about vitamin C and everything.
But he was onto something, and this is what we're seeing now. So I think your work is so important, and your ability to actually communicate this, to look at the science is so important. So talk about how we can think about some of the inflammation process in mental health and metabolic health and what we need to do to fix that.
People are listening, well, I hear this, my mitochondria aren't working, inflammation's connected. How do I start to address that in myself?
But I saw it, and I saw the kind of whispers in the wind let's say, the sort of tea leaves. And I was like, okay, this is really something. And when I started to do this with my patients and when we do this now, we see profound improvements in mood and obviously digestive health and all other areas of health. So gut is just linked to everything.
By the way, the brain has got the most mitochondria per cell of any organ in the body. So it's really important.
But you can do something about it when the baby's born and you can fix the baby afterwards.
So fix the gut, fix the body, fix the gut, fix the brain. I know how powerful this is and how powerful functional medicine is for fixing depression because I also had it. myself. And it wasn't because of something that had to do with my psycho-emotional health, but my physical health. My brain literally broke one day in 1996. I felt like I had ADD, depression, and dementia all at once.
One of the best doorways to the mitochondria is... Exercise, right? It stimulates the growth of new mitochondria, improves the function of mitochondria. It's quite important. And it also cuts down inflammation and activates your antioxidant enzymes. It has so many benefits. And we know it's better that they quill into many drugs for depression if you just exercise regularly, vigorously, right?
And we know that diet also plays a role. And one of the challenges, and I wonder how do you address this with your colleagues? Because this is something I've found even at Cleveland Clinic, working with some of the researchers, they're like, Well, we can't do everything at once. We can't do diet and exercise and supplements and sleep.
And I'm like, we can only do one thing at once because we don't know what's going to work. And I'm like, wait a minute. If you want to grow a nice garden, you don't just go, I'm going to give the water the plant water only, but no soil or sunlight. And then I'm going to give it sunlight, but no soil or water. It doesn't respect the laws of nature.
So how do you kind of battle that within the medical paradigm? Because it's really tough. We're looking for the single drug, for the single disease, or the single outcome, which is a model based on infection, which can work. But even then it's flawed because it depends on the biological terrain and why some people get sick and don't, or why some people die and don't. We see that with COVID.
Not everybody gets sick
I saw lots of doctors, psychiatrists. No one could find the cause, although they wanted me to take Prozac for my symptoms. And no one could agree on the diagnosis. Some said I had depression. Others said I had chronic fatigue. And in fact, I did have chronic fatigue. And I started to de- dive into the literature.
It's like autism, right?
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And I consulted with other doctors and scientists, people on the leading edge of medicine. And I started to do some experimentation. And when I came to understand that it wasn't just one thing that caused my brain to break, it was accumulation of a lot of things. Diet stuff, stress, environmental toxins like mercury was a big factor. My gut was just a mess. In fact, that's what happened.
I had mercury underlying all this. And then one day I got some kind of gut infection up in Maine at a camp. And then boom, my gut was off. And it didn't get back on track for many years until I figured out how to fix it. And all that leads to inflammation. So rebalancing my gut microbiome, getting rid of the mercury. It was messing up my gut because mercury interferes with gut function.
Yeah, you were talking earlier about this idea of comorbidities, which is a term we use in medicine to describe diseases that occur in the same patient. So if you have high blood pressure, diabetes, depression, reflux, we call these comorbidities. But we were talking earlier about how they may not really be unrelated, that in fact, they may be very connected.
And it sounds like from your observations, you made the conclusion that maybe it wasn't a coincidence that the fact that people who were overweight or unhealthy also had mental health issues, maybe there was a relationship, nutritional deficiencies, metabolic issues. You talk a lot about insulin resistance.
So how did you come to sort of understand that that was really going on, that the biology of that was something that was real?
Which is incredible because when you look at the level of mental illness in society, it's one of the biggest causes of disability. And one of the biggest costs is depression and anxiety. And I remember when I was seeing patients early on, treating them for insulin resistance and prediabetes and other issues or gut issues or diabetes.
It was the key to getting my brain and health back. I also saw this with so many of my patients. I had a woman who had severe OCD. She wouldn't clean up her house for years because she didn't want to move things around on the floor. Looked at her health and her biology and try to see what was going on. And in functional medicine, we just take out the bad stuff, put in the good stuff.
other factors that were going on related to autoimmune disease or inflammation, and we would get them healthy, they would sort of say, wait, you know, my depression went away. My anxiety went away. My panic attacks are gone. My bipolar disease is better. My ADD is better. And I'm like, well, how did that happen?
And then you begin to go down the rabbit hole and you begin to look at the biology of what's happening. And one of the, I think the greatest discoveries around mental health is that it's an inflammatory problem very often that the brain is inflamed, but the brain can't say, ouch, like you have a sore throat or, you know, a swollen ankle. It manifests as all these psychiatric symptoms.
So I'd love to be sort of take us down the road of how inflammation is connected to mental illness and what the approaches that you're using to help correct that.
Wait, so your brain chemistry gets screwed up when you eat processed food and sugar, is what you're saying?
So I saw she had a lot of bad bugs in her gut, a lot of overgrowth of yeast, and I gave her basically an antibiotic and a fungal that was designed to kill those particular bugs. And literally overnight, her OCD went away and she was able to clean up her whole house after decades. I also had a little girl who was a sweet little girl, nine years old, but was a terror.
So what you're saying is people who are overweight and obese often are very malnourished and vitamin and nutrient deficient.
That's sort of a paradox, right?
They're eating all this food. Why are they nutritionally deficient? But they're actually among the most malnourished.
They're looking in all the wrong places for the nutrients. They're eating more and more food. And I think a study from Kevin Hall and others showed that if you let people eat as much as they want and you give them ultra-processed food versus whole foods, they'll eat about 500 calories more a day of ultra-processed food because they'll keep eating and they're hungry and they keep driving.
And you talk a lot about it in your work, about the biology of what these do to your brain in terms of dopamine and the addiction reward pathways in the brain that make you... literally become addicted to these compounds and how that affects you.
And it's more like a coffee filter. You know, it's a sip.
She would get kicked out of school all day, on the bus ride home, they'd have to stop the bus 10 times. She was terrorizing her little sister, tearing up pictures of the family, just kind of little nuts. I did testing and she didn't have any gut symptoms, but we found really high levels of bacterial overgrowth and bad bugs in her gut and yeast overgrowth.
People go, it's like emotional eating. It's not really biological, true addiction. What you're saying is this is really a true biological addiction, just like heroin or cocaine or alcohol, that you get withdrawal, you get cravings, you get increased need for more and more of the substance to receive the same pleasure.
You downregulate the receptors for pleasure, so you have to take more of the stuff to actually stimulate that reward pathway. Yeah. And it's really this vicious cycle that people get into. And then they blame themselves and they feel guilty for doing it. And they think they just have no willpower. But you're saying it's much bigger than that.
I call sugar a recreational drug. I've never heard anybody say it, but I always write down in my book, sugar is a recreational drug. It's like if you like tequila, it's fine, but not breakfast, lunch, and dinner in the quantities we're having in America.
Yeah.
Yeah, cookies and toilet paper.
And again, I gave her an antibiotic, an antifungal, and literally overnight, she turned into this beautiful, sweet little girl. So that made me think, oh my God, there's a whole untapped world here that we're missing of how to help people who not only have physical health issues, but also have mental health issues. So today we're gonna dive deep into the gut-brain connection.
No. It wasn't a run on broccoli.
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We're gonna share some functional medicine tools that will help support your gut health and obviously your mood and mental health too. So what is this gut-brain connection exactly? Well, let's go into the science. The human brain contains approximately 100 billion neurons, brain cells. nerve cells, right? The gut also has a nervous system.
It's called the second brain, also known as the enteric nervous system. Enteric just means gut, fancy medical word. And this contains, get this, 500 million neurons. So there's five times as many neurons in your gut as in your brain. Now there's a bi-directional highway between the brain brain and the gut brain. And this is called the vagus nerve.
And it links our enteric nervous system with our brain and their central nervous system. And it's sending and receiving signals all the time. So whatever's happening in your brain, mood, stress, emotions, impacts your gut function. And whatever's happening in your gut impacts your brain function, right? Mind-body, body-mind. We talk about this. I felt sick to my stomach. I have gut feelings.
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Maybe you're so nervous you had to run to the bathroom, right? This is the gut-brain connection at work. There was a study that looked at more than 1.2 million hospitalizations for irritable bowel and 4,000 hospitals.
And people with IBS or irritable bowel syndrome had three times higher risk of anxiety, two times greater risk of depression, and then two times greater risk of suicide ideation, meaning they were thinking of suicide versus the general population. Now we used to think that anxiety caused IBS. But now we know it's the other way around and a little bidirectional. So think about that.
It's not really the stress or anxiety or mental health issues that's causing irritable bowel. It's the change in the microbiome and the irritation, inflammation to the gut lining and the enteric nervous system that feeds back to the brain. It creates an irritable brain. So irritable bowel leads to an irritable brain. So before we dive any deeper, let's define the features of this gut-brain axis.
The gut, which basically we talked about, is the GI tract. It starts at your mouth and it goes to your anus. It includes esophagus, stomach, small intestine, large intestine, all the way down to the bottom. The vagus nerve is the longest nerve that comes from your brain called the cranial nerve.
It travels through the brainstem to the gut and it connects the gut to the central nervous system and it goes through the entire higher GI tract. Think about it. You've got huge amounts of gut. If you, if you laid out your small intestine flat, it would be the surface area of a tennis court. And then there's your large intestine and then your esophagus. So all that is really important.
The vagus nerve connects to other things like your heart and lungs and so forth. But this vagus nerve is a really important part of your nervous system called the parasympathetic nervous system. This is the relaxation nervous system. It also is called the autonomic nervous system or automatic nervous system.
So it's not usually under our willful control, although we can regulate it through various practices. The yogis have been doing this for centuries. It regulates involuntary sensory and motor functions. You say, I'm going to move my arms. You move your arm, but you'll go, oh, I want to digest my food. Can you please digest the food in there? Can you please regulate my heart rate?
Can you control my blood pressure? You don't really think about it. These things happen automatically. A lot of this happens through this automatic system. There's a lot of signaling that happens through this nervous system. For example, it helps control appetite. And how does it do that? Through a peptide hormone called GLP-1, right? You might've heard about this. This is...
Ozempic, Rigobi, and so forth. Manjaro, these are drugs now, quote drugs, but they're not really drugs. They're just mimicking your body's own GLP-1 at a much higher concentration. This is also known as the satiety hormone. I mean, it makes you feel full, which is why people don't eat because they take this shot and they don't feel full.
And this is also why people lose weight because they take this shot They feel full, they don't want to eat as much, and they lose weight. This is typically secreted in the lower part of the intestine, but it basically reduces your appetite and promotes satiety. And it sends a single via the vagus nerve. So this is really important, this drug, right? It's Ozempic.
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So this is something your body makes. Also, there's other hormones that are regulated called CCK or cholecystokinin, peptide YY, really important. And other compounds called short-chain fatty acids. We're going to talk about why they're important. But these are made by your gut and suppress appetite by making you feel full by activating the vagus nerve. And these are things that you can regulate.
Leptin is another hormone produced in fat cells and in the gut. And it's also the feel-full hormone. There's many of these redundant pathways in your body. And it exerts its effects through the vagus nerve. This network, this gut brain, this second brain or enteric nervous system is a vast network of, like I said, almost 500 million neurons. It's embedded in the lining of the GI tract.
What's in them not only is nerve cells, but also hormonal cells, right? Enteroendocrine cells. And they're throughout the entire GI tract. And they're involved in sensing all sorts of signals, right? What nutrients you're taking in, taste, mechanical stimuli, fiber. They detect the microbes, what's going on in there. They help sense toxic compounds. So it's really a critical system.
And as I mentioned, this is called the second brain. It operates independently, but also with the brain brain, right? The central nervous system by the vagus nerve, and it controls everything, right? Gut motility, right?
Whether you're constipated or have diarrhea, enzyme secretion, digesting your food, hormone release that regulates appetite, and then mention the full hormones or the hungry hormones like ghrelin. And it also affects blood flow that aids in digestion and absorbing nutrients. So it's super important. And the microbiome consists of about 100 trillion microbes, 5,000 different species.
And you got about two pounds of poop in there of microbes in your GI tract. So what do these microbes do? Well, they help you digest your food. They produce vitamins. They regulate hormones. And they help you get rid of toxins. It interacts with your whole enteric nervous system and central nervous system. So the microbiome is a whole other thing that's involved, right?
You don't just have your brain brain and your second brain. You have your microbiome brain, let's call it, right? It's really important. And it helps regulate everything in your body. And it regulates mood particularly a lot.
Now the composition of your gut microbiome, and I'm going into this because it's important to understand if you're going to understand what to do about fixing your gut and how this all works, because I want you to understand the importance of understanding your gut as it regulates, regulating your mood and brain health and pretty much everything else.
So the composition of your gut flora, it varies from person to person. It depends on their diet, right? So if you're a hunter gatherer, and eating meat or bison all the time, or if you're a vegan, all that changes based on what you're eating. It changes based on your lifestyle, stress, toxins, genetics, all regulate the microbiome.
Now there's a large research project going on called the Human Microbiome Project. It helps map out the gut microbiome of individuals who are healthy and who who are sick to understand better their gut bacteria species. So what defines a healthy gut? What defines a sick gut? And how does that relate to different diseases?
Now what's amazing also to me, this blew my mind when I learned about it, is it a third to a half of all the metabolites in your blood, All the thousands of molecules floating around your blood that regulate everything in your body are not human. They're from your gut microbiome.
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In other words, these molecules produced from bacteria in the gut are absorbed and then impact your whole biology, including your brain and your mood. There's still a lot we don't know about what makes a healthy gut or a sick gut, but we know a lot. Now, your gut microbiome can produce healing metabolites that keep your gut and immune system healthy. Things like short-chain fatty acids.
We'll talk about those soon. Vitamins like B12, for example. Riboflavin made in your gut. Enzymes. Or it can produce harmful metabolites. So bad bugs produce bad stuff. Good bugs produce good stuff. And the bad metabolites from bad bugs can be things like cytokines. We've learned about from COVID, the cytokine storm. These are inflammatory messenger molecules of your immune system. Endotoxins.
literally poisons. We call these lipopolysaccharides. These are endotoxins, things that are toxic, produced by bacteria that can be absorbed across a leaky gut, cause you to be inflamed and create disease, including obesity and mental health issues and much more. So bad bugs make you inflamed and almost all issues related to mental health.
And it's really important to understand almost all mental health issues and brain issues, whether it's Parkinson's, Alzheimer's, autism, ADD, depression, anxiety, bipolar disease, schizophrenia are all caused by inflammation in the brain. So if we fix the inflammation, we can fix many of these things. And we'll talk about how to do that soon. Now, what is this gut mood connection?
We talked about, so what is the gut and what is the gut brain and the second brain and the first brain and the hormones? Okay, we talked about all that. So the gut microbiome actually influences brain health and function, and it impacts your mood, impacts your stress level.
So literally you can have stress molecules produced in your gut that are not because of something happening outside, but something happening inside. And it increases the risk of depression, mental illness via a complex network of things. nerve cells, endocrine cells, or hormone cells, immune pathways. It's the psychoneuroendocrine immune system, right? We talked about this a lot.
It involves all sorts of activities like the transport of neurotransmitters, tabloids, cytokines, and certain species of gut bacteria are directly involved in the production of neurotransmitters affecting both the gut and the brain. Let's talk about some of them. So dopamine, for example, is best known for its role in reward pathways, pleasure, motivation.
For example, we know about Adderall or these... ADD drugs, they all stimulate dopamine pathways. Sugar does. All the addictive compounds we like too. So does altruism, by the way. By the way, there are certain bacteria that help increase dopamine. Things like lactobacillus plantarum, bacillus subtilis, bacillus cereus, and certain strains of E. coli that are beneficial. Pretty cool.
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What about serotonin? Another important neurotransmitter involved in mood. It's involved in regulating various physiological processes, including the secretions of your intestinal tract, peristalsis, motility, respiration, blood vessel regulation, behavior, mood. We know all about Prozac. That's how it works through inhibiting serotonin reuptake in the nerve cells in the brain, which
makes you have more serotonin. Now, certain bacteria that are good can actually help improve the concentration of serotonin. And by the way, 90 to 95% of serotonin in the body is produced in the gut. But bacteria like Lactobacillus plantarum or Streptococcus thermophilus, which are healthy bacteria you can get through supplements or you can help
help grow their diet, actually help with improving serotonin. What about GABA? This is the relaxation neurotransmitter. It's sort of the receptor upon which Valium and the Benzos work. So GABA is sort of a relaxation neurotransmitter and it helps reduce neuronal excitability, helps reduce anxiety and stress. sleep.
And a lot of bacteria can help produce this in your gut, like bifidobacterium, lactobacillus plantarum, lactobacillus reuteri, lactobacillus rhamnosus, even things like acromantia. We talked about this a little with Darlene from Pendulum Therapeutics. She basically was growing acromantia in this big vat to be a probiotic.
And they started to analyze what was in one of the metabolites that the acromantia was producing. And they actually found a big spike and it turned out to be GABA. So this acromantia bacteria, which is so important for so many reasons and have many podcasts and things we've written about it I'll share it in the show notes. Acromantia actually produces GABA. So it's like a natural valium.
Other bacteria can influence the levels of neurotransmitters by encoding genes for enzymes that produce neurotransmitters or directly impacting the synthesis of neurotransmitters or the breakdown of neurotransmitters. So the microbiome plays a huge role in all sorts of neurotransmitter function.
For example, the conversion of neurotransmitter precursors like tryptophan you get from your diet into serotonin, which is the happy mood chemical. They're also involved in the production of a really important compound in the body called BDNF, BDNF means brain derived neurotrophic factor.
Right. So the rates of obesity and binge eating and addictive-like eating are rising alongside the increasing dominance of ultra-processed foods in the modern food environment. And there are several mechanisms as to how this works, some which act directly on the brain and some that indirectly act through hormonal signaling. So our body is very complicated and the brain is connected to the body.
And we used to learn in medical school that you have this blood brain barrier that nothing can get across it. But that's not, it's like the Berlin Wall. But in reality, it does leak, right? And there are things that do cross.
Yeah, so ultra-processed food and sugar decrease our dopamine receptors and make us eat more compulsively. Much like addictive drugs, the highly processed foods, they trigger dopamine reward pathways and they invoke addictive-like behaviors, which have been well documented and include intense cravings, includes feelings of withdrawal when cutting down on ultra-processed food.
continuing to eat these things despite knowing the adverse consequences to it, and repeated attempts to try to quit, right? I'm describing addiction here, basically, and the consumption of larger quantities over time than intended.
It's So sugar is an addictive substance. It's not Just something we say it has a straightforward neurochemical basis in the brain just like any other drug and I think of sugar as a It's a recreational food. It's not a food that's essential for survival. We make sugar through the process of gluconeogenesis, through other foods that we consume. It's really about excess carbohydrates.
Exactly, yeah. Actually, I would like to share a story about this. Just during the era of COVID, since we're in it, just to give context as to why I wrote about this and why I'm working on this as well and continuing to feel motivated to continue to do my work is The shelter-in-place order had come, you know, a couple months back for my county, and I'm in California. I live in Menlo Park.
When it was announced, my husband, he's an infectious disease physician at Stanford, and I'm a psychiatrist and a medicine physician, as you... mentioned, we both felt doubly invested in this pandemic. We went to our neighborhood Safeway grocery store and we saw many people loading up their carts with Pop-Tarts, Hawaiian Punch, popcorn, anything ultra processed, basically.
And they weren't loading up their carts with fresh vegetables or, you know, they were out of cookies at the grocery store.
And toilet paper, exactly. And there were still, you know, produce left in the store. It wasn't like they ran out of produce.
No. Here I was at the checkout counter and I was thinking to myself, staring at the person's cart in front of me that was full of the recreational food, as I mentioned, the food that's not necessary for survival and detrimental to our health. I thought to myself, this is certainly not preparing them for the pandemic. or helping their immune system and, if anything, weakening it.
And this is our local Safeway. This is the heart of Silicon Valley. So in this context, it wasn't about affordability or access. That is what motivated me to kind of get that public message out on this topic.
Yes. What I have noticed is that a lot of my patients that come for psychiatric treatment and evaluation, a lot of them have pre-diabetes and diabetes. And when I look up the statistics on this in our country, 44% of adults today in our country are either pre-diabetic or they have diabetes. And I wonder to myself, what is that doing to our brain?
We know that affects all these different organ systems, the liver, the pancreas, the heart, but what is that doing to the brain, right? And so, I'm happy to talk more about my research and patient care. But one thing that I felt I didn't completely answer before was kind of how these hormones affect the brain with the addictive piece.
Yeah. Yeah. So kind of going back to that, you know, so I was talking about the definition of addiction. And we know that hormones like insulin and leptin, which is the hormone that tells us we're full, it sends a signal to our brain, and ghrelin that tells us that we're hungry, these hormones modify natural and drug reward pathways in the brain. I mean, they have so many effects on the brain.
Our hunger hormones go awry and it can actually increase the reactivity itself of the dopamine system. And so this happens when we consume that excess sugar and the excess carbohydrates in our diet. And they cause these rapid shifts in blood glucose and insulin levels similar to other addictive substances. So my approach in patient care has been to work on this system to decrease
these shifts that occur in our blood sugar and our hormone levels to kind of go back to the homeostatic state that our body and our brains were meant to be in. And so I treat the metabolic dysfunction and I look at how that improves both metabolic issues as well as psychiatric outcomes.
So the field has come a long way. There's a lot of research that's been done on the biological piece and neuroscience and looking at obviously the serotonin hypothesis, but that's a hypothesis and an observation from like 30 years ago.
And all of these research and money has been thrown on developing drugs, but we're not necessarily addressing some of the root causes of why are these chemicals imbalanced. And so That's an important question that I and others are trying to study through research studies and clinical trials.
And like you said, we know that although our medications are necessary and lifesaving for many, they have undesirable side effects that can worsen metabolic health. And while it's helping in one domain, it may in some people also be hindering improvement in psychiatric symptoms, especially if the metabolic health is poor. So psychiatric treatment is never going to be a one-size-fits-all approach.
Mental health conditions are varied. They're heterogeneous and they have different phenotypes or presentations. We don't have a single mutation. or a gene that we can point to, or a lesion. There's no smoking gun. It's a complex relationship of multiple genes and environment. And unfortunately, a metabolic assessment is not part of that routine care, and stigma certainly plays a role in this.
Obesity is stigmatized, and so is mental health. education about nutrition and metabolism was lacking in medical education. Most psychiatrists recognize this relationship.
They're starting to. They understand that there are side effects with psychotropic medications. I think they don't necessarily have the expertise to treat it or address it. They don't know necessarily what to do about it. But most psychiatrists that I speak with, and my department certainly has been very supportive of this idea,
And someone has to do the research and someone has to do the work to kind of move the field forward. And there's a growing body of other researchers working on this. And we hope that evidence-based research has to be done to kind of change the mainstream standard of care.
I think that is changing. There's a complex relationship between metabolic dysfunction and nutrition, food, mental health. And I want to start off by saying that the idea of food as medicine is not a new concept in the field of nutritional psychiatry. It's really grown over the past few decades by several prominent psychiatrists and researchers.
However, the focus has largely been looking at specific foods or supplements, eliminating certain things from the diet, the microbiome, or looking at the Mediterranean diet, for example, affecting depression symptoms?
And these are all very important questions, but what I thought was missing and why I named our clinic and our group's work metabolic psychiatry is to distinguish that this is a study of how treatment of metabolic dysfunction can affect psychiatric symptoms. If a majority of us are suffering from obesity, type 2 diabetes, insulin resistance, metabolic syndrome, What is that doing to our brain?
We know that these diseases affect multiple things. Mental illness rates have increased over the past 20 years, in fact doubled. We know that mental illness like depression, bipolar disorder, psychosis, they're strongly associated with inflammation. That research is really indisputable. And research is also showing that there's an energy deficit in these brain illnesses
and the mitochondria the energy powerhouses of ourselves are not functioning optimally causing changes in brain signaling itself and the thought is if we can target inflammation insulin resistance the abnormal blood sugar etc as a method to improve mental health symptoms then we can really improve our patients lives further and
Again, mental illness has many different causes, but even if we, you know, can 5 to 10% of people have an improvement in these symptoms with this method, then I think that would be a pretty significant improvement of the overall mental and physical health of our country.