The Dr. Hyman Show - What’s Fueling Our Mental Health Crisis and How Can We Fix it? | Dr. Jaquel Patterson

Episode Date: August 14, 2024

Did you know that inflammation could be the hidden culprit behind the skyrocketing rates of mental illness? In this episode, I sit down with Dr. Jaquel Patterson to discuss one of today's most pressing issues: the alarming rise in mental health disorders like depression, anxiety, ADHD, and bipolar disorder. We explore the connection between mental health, inflammation, and immune function, shedding light on post-COVID mental health challenges, brain inflammation, and the impact of environmental factors. In this episode, we discuss: The mental health impacts observed post-COVID, highlighting the exacerbation of pre-existing conditions and new onset issues. The connection between brain inflammation and mental health disorders, emphasizing the role of chronic inflammation in conditions like depression and schizophrenia. The impact of environmental toxins on mental health. The potential benefits of sauna therapy for reducing inflammation and improving mental health. Functional medicine strategies for treating mental health disorders, including dietary changes, nutrient supplementation, and lifestyle modifications. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal This episode is brought to you by Rupa Health, ARMRA, Thrive Market, and Fatty15. Streamline your lab orders with Rupa Health. Access more than 3,500 specialty lab tests and register for a FREE live demo at RupaHealth.com. Save 15% on your first order of ARMRA Colostrum and unlock the power of 400+ functional nutrients. Just visit TryARMRA.com/Mark or use code MARK. Head over to ThriveMarket.com/Hyman today to receive 30% off your first order and a free gift up to $60. Fatty15 contains pure, award-winning C15:0 in a bioavailable form. Get an exclusive 10% off a 90-day starter kit subscription. Just visit Fatty15.com and use code DRHYMAN10 to get started.

Coming up on this episode of The Doctor's Pharmacy. The benefits of like sauna and how that showed to decrease CRP levels and also in studies that they did in Europe for men that there was like decreased chance of like things like schizophrenia. That's crazy. Wait, I just want to stop there. You just said take a second sauna can help reduce psychiatric symptoms and even schizophrenia. Exactly.

Hey everyone, it's Dr. Mark. As a functional medicine professional, I'm always on the lookout for innovative solutions to improve patient care. Exactly. all in one convenient location. That means no more time-consuming paperwork or administrative nightmares. Just a simple, efficient lab-boarding process that I know you'll love. And the best part? It's completely free. That's right, there are no hidden fees or complicated billing systems. Just one invoice, paid online and up front.

So why wait? Sign up free at rupahealth.com and take control of your lab-ordering process today. That's rupahealth.com. Everyday exposure to chemicals, pollutants, allergens, and processed ingredients can disrupt your body's natural barriers in the skin, lungs, and gut, leading to the root cause of modern health problems like inflammation. But a powerful food backed by extensive research can help strengthen these barriers. Armrock colostrum.

Colostrum is the only food in nature made for the human body and is the first nutrition we receive in life in order to fully thrive. Armrock colostrum harnesses the power of colostrum is the only food in nature made for the human body, and it's the first nutrition we receive in life in order to fully thrive. Arm Rock Colostrum harnesses the power of colostrum's over 400 functional nutrients to strengthen your body's barriers and optimize cellular health for thousands of whole body benefits. Arm Rock Colostrum supports your entire gut wall system, which guards against irritants that can trigger symptoms like bloating, constipation, and irritable bowel syndrome. And because it works at the foundational level, thousands of users report enhanced skin radiance,

fuller hair, stronger immunity, and increased metabolism. It's even been shown in clinical trials to promote lean muscle mass, a critical component of longevity. We've worked out a special offer for my audience. Receive 15% off your first order. Go to tryarmra.com forward slash mark and enter the code mark to get 15% off your first order. That's T-R-Y-A-R-M-Rarmra.com forward slash mark and enter the code mark to get 15% off your first order. That's T-R-Y-A-R-M-R-A.com forward slash mark. Before we jump into today's episode, I'd like to note that while I wish I could help everyone by my personal practice, there's simply not enough time for me to do this at this scale. And that's why I've been busy building several passion projects to help you better understand, well, you. If you're looking for data about your biology, check out Function Health for real-time lab insights. If you're in

need of deepening your knowledge around your health journey, check out my membership community, Hyman Hive. And if you're looking for curated and trusted supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite and tested products. Welcome to Doctors Pharmacy. I'm Dr. Mark Hyman. That's pharmacy.f, a place for conversations that matter. And if you've struggled with mental health issues, if you know anybody who has, which is pretty much everybody in America that has had or has experienced someone in their family or friend who's had mental illness, you're going to need to listen to this podcast because it's with the pioneering physician, Dr. Jaquel Patterson, who spent a lot of time diving into why there are so many problems with mental health in

America and what are the root causes? How do we think about things differently? She's been published in many journals. She's a well-known speaker. She's had 16 years of clinical experience. She's on the board of the American Academy of Environmental Medicine. She's a certified functional medicine practitioner. She's got her MBA, and she's just so focused on trying to make the world a better place by getting patients the help they need through the right approaches of functional medicine. So I hope you love this podcast. Let's dive right in. Welcome to the Doctors Pharmacy, Jekyll. It's great to have you, and I'm so excited about our discussion because it's going to address one of the biggest crises we're facing today, which is an explosion in mental illness and the explosion of crisis in mental health.

We're seeing dramatically rising rates of depression, anxiety, ADD, bipolar disease, suicide rates. I mean, just all the numbers are going through the roof. And the question is really, what is going on out there and how do we deal with this differently? Because our traditional approaches in psychiatry really have not adequately dealt with the crisis in mental health. And despite better medications and lots of medications, I mean, I think psychiatric medications are the leading category of drug sales, or maybe the second, actually. I think it's the second, actually, after statins. We're not making a lot of progress.

People don't really get much better from these drugs. The data on the effectiveness of them is sort of not that impressive. Sometimes often no better than a placebo. For some people, they can be effective, but it's really missing the very fundamental idea about what's causing this. I remember learning about psychiatric disease in medical school, and basically we're really good at classifying people according to symptoms.

What are the symptoms that indicate you have depression or ADHD or anxiety or OCD or whatever it is, bipolar disease. And they were just descriptive, but they didn't tell you anything about the cause or the mechanism. And it's kind of been a black box, right, because basically the joke is neurologists pay no attention to the mind and psychiatrists pay no attention to the brain. But brain dysfunction, it doesn't show up like other parts of dysfunction in our body. If we have

arthritis because our joints are inflamed, well, we get a swollen joint and it hurts. But when our brain's damaged or inflamed, which we're going to talk about, it doesn't show up as pain in the brain. It shows up as psychiatric symptoms. Yes. And so we kind of misappropriate meaning to these diseases, which we have seen just skyrocket in the last decade or two. I wrote a book called Termine Solution 15 years ago, and it was a lot then. And it's getting worse and worse. It's getting worse.

It's like watching a slow-moving tsunami. And I remember reading a book when I was in college called Madness and Civilization by a French philosopher called Michel Foucault. And he was very good at describing the historical context of mental illness throughout the ages. It was visitation by God or possession by demons or evil humors or whatever thing. Or maybe it's your Oedipus complex with Freud or whatever the kind of latest version of the story was about psychiatric illness. And the truth is it kind of mostly missed the mark about what's really going on. Because we see things and we put labels on them, but we don't really think about the cause. And what I'd love to talk to you about today is your experience as a clinician in the trenches, seeing people

with a whole array of mental illnesses that you've been able to sort of unpack through the lens of functional medicine rather than the old model, name the disease and give the person a drug for that disease, right? And so I'm curious how you sort of started getting into, as a practicing clinician, what got you into this idea that we should be thinking differently about psychiatric illness? Well, I actually, as a naturopathic physician, been practicing for over, you know, 15 or 16 years. And one of the things, Lyme disease was something I struggled with myself, also other family members, and treating patients with that, I started seeing a much larger growth of individuals with symptoms of anxiety and depression and mood changes.

And it really forced me as a clinician and people practicing in the space, in functional medicine space, were getting to the underlying cause, to find out why. What are the reasons? What are the causative agents? And so for many of my patients at that time that were struggling with it, I would see as I worked on the infection or worked on inflammation or immune tolerance, their symptoms or mental health symptoms went, you know, significantly improved or they were able to get off medication or it was no longer an issue. And so that's why I kind of went back,

did additional two years of training in functional medicine, also in addition to ADHD. And there's so many factors that we don't look at, you know, environmental factors, outside of things like genetics, because people often blame it on genetics, or I have a family history, which is definitely a contributing

factor. But there are a lot of other factors outside of that, including infections, including, you know, trauma, including even TBIs and things like that. I'll see my patients. Yeah, traumatic brain injury will be significantly worse if there's also history of multiple concussions. So just we want to look at at that full picture and there's more than just neuroinflammation, but it's a huge factor that a lot of physicians don't look at in their workup when they're working with the patient with mental health issues. Yeah. I mean, I think that's really interesting because I had the same experience. You know, you, you came at this through treating patients with Lyme disease and infections, which are inflammatory diseases. And basically by treating their body, their brains got better.

Exactly. And I had the same experience when I was treating patients years ago. I started to see, I was treating their gut or their allergies or some other inflammatory problem and using the principles of functional medicine to restore balance in the body. And their psychiatric symptoms would get better, it was uh things even like psychosis or adhd or depression or anxiety or ocd or bipolar disease i was like this is really crazy because this doesn't this isn't anything i ever read in a textbook like i when i wrote that book 15 years ago it wasn't like a big thing back then we're talking about the microbiome or nutritional psychiatry or metabolic psychiatry

or the microbiome and psychiatry. Now it's out there in these major academic centers. We've had many of the researchers from these centers on the podcast, and we'll link to their podcast in the show notes. But it's been sort of a revolution. And the problem is most people suffering out there don't know this. And so I'd love to sort of unpack a little bit about what are the causes of this sort of rise in mental illness and what can we do about it? Like, where do we start to think about it? How do we start to think about the causes? What are the reasons? You mentioned neuroinflammation. What is that? How does it work and what causes it? And, you know, is that the only thing that's driving this crisis? And so help us understand that. Anxiety, depression,

mental health disorders have been, you know, on the rise. But after COVID, the pandemic increased significantly, especially for adolescents and young adults, where you'll see, for example, one out of three individuals at some point in their life have struggled with anxiety. For depression, for adults, it's about around 10%. But when you look at adolescents, it's around 15% for depression and almost 30% for anxiety. And also the leading cause of death is suicide for that age too. So I think it's a multifaceted loneliness, isolation, technology, social media, those things that we do, which affect the neurotransmitters like dopamine, norepinephrine, and epinephrine, which affect your reward system, etc. But also infections, they have shown that after COVID, some of the individuals that actually had COVID initiated or potentially initiating factor for autoimmune conditions, like type 1 diabetes actually was one of the ones, lupus, MS. So there have been

increases you can see in autoimmune conditions as well since 2020. So there's definitely a correlation between that. Basically a COVID-related autoimmune disease. Exactly. So you have like inflammation, I say, is like the first step. Then there's immune tolerance or immune dysregulation, then followed by psychiatric conditions. So if you look at autoimmune conditions or individuals with chronic disease conditions like type 2 diabetes, they're much more likely to have higher rates of mental health issues. And there's even studies that have shown like higher levels of this enzyme called C-reactive protein, which is part of an inflammatory protein that usually goes up initially with inflammation, that high levels of CRP as a child

increases significantly risks of schizophrenia later in life. And so that is chronic inflammation as a child is going to also increase your risk for mental health disorders. Yeah, it's quite amazing when you think about the fact that psychiatrists never looked at the brain. And now psychiatric medicine is starting to look at the brain and doing even brain biopsies on people who've died who've had certain conditions like autism or schizophrenia or looking at spinal fluid. And what they're seeing is literally these brains on fire. And if you look at every single brain disease, pretty much, you know, Alzheimer's, Parkinson's, depression, anxiety, ADHD, autism, bipolar disease, schizophrenia. If you look at the brains, they're literally inflamed, like you'd have a swollen joint or a

sore throat. And so in traditional psychiatry, there's really no treatment for it. And we're like, take Advil. Is that going to work? Probably not, right? There are actually even studies I've seen using biologics like TNF-alpha blockers, which are basically massively expensive, extremely powerful, immune-suppressing medication that have significant side effects. And they're talking about using that for depression as opposed to figuring out what the upstream causes are. Yeah, why is the inflammation happening in the first place? Yeah, classic traditional medicine. It's like, okay, well, it's inflammation in the brain. Okay, I got that. But let's figure out what drugs we can use to shut it off. Let's do chemo drugs.

Let's do steroids. Let's do biologics. Let's do Advil. It ain't going to work. Because one of the fundamental reasons of functional medicines, if you're standing on TAC, it takes a lot of estrogen to make you feel better. Take out the TAC. Remove the cost, right? And so from your perspective, what are the fundamental causes of this acceleration in brain inflammation? And let's sort of unpack some of those and get into how we can start to diagnose them and how we can start to treat them. So chronic infections are one. So area of focus for me in practice is Lyme disease and tick-borne diseases. Those have been heavily connected also even to other conditions like PANS and PANDAS that

children will have, which causes acute inflammation of the brain. Neuropsychiatric is called Pediatric Acute Neuropsychiatric Syndrome. And that can be initiated from an infection like strep or walking pneumonia, where the body is actually inflamed and attacking attacking itself but triggered more towards the brain so what happens is you have in your body you have what's called the blood-brain barrier and that keeps things in and out for the most part we keep most of the things out there might be like a couple one or two percent that can get leakage of solutes

etc that'll go through the brain. Then after that, what happens is you have these, what's called microglia. There's, it's part of the CNS, it's called the glial cells and microglia gets activated. And what microglia, yes, for the brain and microglia acts, like I say, it's like a cleaner. So it's coming in to help clean out, you know, any inflammation debris. And so if it's highly activated, where you're seeing someone where the microglia is more active, there's more work it's doing to actually clean up these inflammatory mediators. And what ones that are triggered for anxiety and depression are things like interleukins, like IL-6, IL-1, TNF, tumor necrosis factor, those will also go up when there's chronic brain inflammation.

So those are cytokines. Those are cytokines, yes. I was talking about the cytokine storm from COVID. These are bodies, immune messengers that are good when there's something acute, like an infection that you want to fight and you want to bring inflammation to, but they're not good if they're chronic. If they're chronic, exactly. And so you'll look at IL-6, which precedes CRP, which I mentioned earlier, and that was shown to be highly elevated for individuals like post-COVID, long COVID, or have had chronic issues.

So that one has been definitely connected with really any chronic disease condition, and especially things like depression. It's one of the reasons why there's been tons of studies on things like turmeric, curcumin to help with depression. In fact, one recent study had showed having curcumin in your diet. So I know you do a lot on food and diet that increases up four and a half times of like stress resilience of just having that in your daily diet.

And that's because of inflammation. And we're continuing to be like an inflamed society based on environmental burn-in plastics toxins metals like mercury and lead will increase up inflammation um uh actual trauma to the brain chronic disease which influences circulation blood flow etc infections like i mentioned. So many different causative agents of it. Yeah. I'm generally a very happy person and I've always been happy. And I remember when I was very sick with mercury poisoning and then Lyme disease and Babesia, I felt physiologically depressed and cognitively impaired. And it was interesting to me because I kind of knew, like my higher self knew, I wasn't depressed.

I wasn't psychiatrically depressed, but there was some process going on in my body that was affecting my brain and literally causing me to have a broken brain. And we see this so much in our patients. And you mentioned a few things like latent infections and tics. It could be viruses. It could be your microbiome out of balance and dysbiosis.

You mentioned environmental toxins like I had the mercury. That definitely causes anxiety, insomnia, depression. It could be diet and inflammatory diet. You talked about anti-inflammatory effects of curcumin, but there's an American diet we're eating, which is primarily processed food or ultra processed food, to be more specific, which is about 60% of our diet that's driving systemic inflammation in the body. So we see a lot of the reasons why we're getting this increase in psychiatric illness. And yet the people who most need help are not really getting the answers.

Yes. How do you start to approach someone who comes in with, because you're obviously seeing a lot of Lyme patients, but are people coming to you just for psychiatric stuff? Yes, yes. We have a lot for solely anxiety and depression, also ADHD. We see a lot of children for that because often parents are looking at what else can I do before I have to put them on medication. It's like 14% of kids are on medication. It's very, very high. And you look at like when you just mentioned diet diet they've had studies on like flavonoids which are in uh more colorful colorful like citrus fruits berries things like that they've shown increases in just having that

amount has helped with anxiety and depression so when you look at things also like adhd anxiety mental health there sometimes is the um we first have to work on like, what is their actual food and diet like, you know, because that's the basic, because if they are deficient in minerals, like iron, magnesium, zinc, those three are heavily connected with like, how your dopamine, norepinephrine, epinephrine focus, all of those factors. So those are huge things to first also initially look at. So it's not just the things that are driving inflammation like, you know, inflammatory foods like sugar and processed food, not just toxins,

not just infections, not just the microbiome, but it's also what we're missing. Exactly. I just, as you were talking about, as a case of ADHD, I had a little kid I treated who just lived on junk food. He had all these allergies and all these other health issues uh gut issues headaches anxiety uh you know irritable bowel i mean just the whole gamut of different things asthma insomnia everything but he had really bad

adhd and you know but when we looked at his diet he was eating pretty much all processed food and not never a vegetable in sight and so he was massively deficient in you know, but when we looked at his diet, he was eating pretty much all processed food and never a vegetable in sight. And so he was massively deficient in, you know, all sorts of nutrients, particularly ones you mentioned like zinc and magnesium, as well as some of the B vitamins, which are important in mood health. Can you talk about, you know, the role of some of these nutrients? Because I think, you know, we don't realize this, but 90 plus percent of Americans are deficient in one or more nutrients at an optimal,

at the minimum level to prevent a deficiency disease, not the optimal level we want for health. So what I might say is how much, you know, vitamin D do you need to not get rickets? Probably 30 units. How much do you need for optimal health? Maybe 3000, right? Yes. And they, and they're in tons. So like you look at iron, I've seen a lot of people's changes in their blood work with like ferritin and iron levels, which increases the blood flow to the brain. So of course, you're also going to be tired or having brain fog, et cetera. So nutrients are hugely important. Magnesium, when we look at it, most of the population is something like over half or more than half. I think it's like 80% are deficient in magnesium because we're not getting it from the soil. But B vitamins, when you look at things like B6, B12, folate, those are all connected nutrients,

really important for mental health. And also they also help to feed the adrenal glands and thyroid. So, and they get depleted when you're more stressed. So the more stressed we are, the more B vitamins we're going to consume. And the only way you're getting that is from either diet or nutritional, you know, by nutritional supplementation as well. So that is kind of one of the first starts I have with patients. And also many of those many medications, that's what usually the first to get impacted are those is B vitamins, are cocaine, antioxidants. I mean, people don't realize that you're right. Like people don't realize that, you know, oh, don't, don't take this vitamin if you're on this drug.

But it's actually also true the opposite. If you're on a lot of medication, you're losing a lot of nutrients. Exactly. So you need something to augment it. So you become deficient in those things that often help, particularly with the mitochondria, like B vitamins. Yeah. And, you know, we're here at the annual International Conference on Functional Medicine here in Las Vegas. And you're giving a talk soon, which is really about the interplay of immune function and psychiatric health.

And in there, you talk about this not just sort of at a high level, but you talk about some of the real specific mechanisms that are underlying this. And let's sort of get into some of the science and the biology around this, because you mentioned magnesium, for example, but a lot of the inflammatory things that we're doing that we mentioned affect this part of the brain that is something called an NMDA receptor, which is stimulated in ways that can be overstimulated to actually cause psychiatric symptoms. And also it could be linked to dementia and so forth. But for example, magnesium plays a role in regulating this. Yeah, and MDA receptors. When you look at even vitamin D, vitamin D has shown that people that are,

with have autoimmune conditions or chronic disease conditions, the lower their vitamin D levels are, lower than 40, the worsening of like the actual symptoms. Like their symptoms are more pronounced. And so, and MDA, we worsening of like the actual symptoms, like their symptoms are more pronounced. And so, and at NMDA, we look at things like, because it can affect GABA and, I mean, glutamate and GABA in terms of altering what that balance is. And glutamate will be more of an excitatory neurotransmitter. So that's going to cause mood changes, irritability,

a lot of variability in the mood itself. That's why when you have MSG, you get the MSG headaches and brain fog. Exactly. Because that's monosodium glutamate. And GABA is basically another neurotransmitter that's kind of like Valium in the brain, right? Yes, and it's like an inhibitory neurotransmitter. And so it's interesting when you look at inflammation, especially for things like schizophrenia and depression,

markers that are actually anti-inflammatory, like IL-10, for example, go down. And then the markers that are more pro-inflammatory, like IL-6, will go up. And so those, like IL-10, is actually connected to dopamine, which is related to depression and mood. Also GABA, there's a change where GABA will go down, which actually helps to support anxiety and to make you feel better. And so you'll see this kind of shifting where it's like more glutamate and things that are

more triggering to the brain and inflamed versus things that are kind of more calming, like a dopamine or a GABA. So we're basically taking in too many things that are driving brain inflammation, and we're not doing the things that help reduce brain inflammation through our diet or lifestyle or exercise or, you know. The balance is completely off. Yeah. And, you know, it's really heartbreaking because you and I see this in our practices

that it's not like we can cure all mental illness from all patients from all things, but this model of functional medicine psychiatry is actually a profoundly effective model for treating mental health issues if people understood what to do. And we've had Christopher Palmer on the podcast who's talked about brain energy and the metabolic and mitochondrial dysfunctions underlying psychiatric disease and treating schizophrenia with a ketogenic diet. These are highly anti-inflammatory approaches. Yes. And so what have you seen clinically in your practice when you start to apply this? What are the kinds of things you're discovering? What are the tests you're doing to help identify these problems? What are the treatments you're starting

to kind of apply to help people with this problem of neuroinflammation? Well, there's a lot of different tests. So one thing I say is through the conventional labs, you are going to look at the inflammatory markers, like I mentioned, CRP, IL-6. You might want to look at ESR, some just basic core inflammatory markers, because oftentimes someone with mental health issue, they're not running. They're not looking at inflammation as it relates to. They might run it for a different reason, but they're not necessarily looking at it. If you're depressed, you basically get a B12 and a vitamin D. Exactly. And a thyroid, you basically get a B12 and a vitamin D. Exactly.

Thyroid, you know. Yeah. And so you want to look at those other nutrients like RBC zinc, RBC magnesium, all the core nutrients that you can do. We also, I also do urinary tests or specialty urinary tests to test for the neurotransmitters. So I look at that. I also look at other factors that can contribute that people don't necessarily think of, like histamine and allergies. Like I was in practice when you asked that question, I started seeing a group of a lot of kids that would come in every time the season changed. And histamine-

With worsening psychiatric- Yeah, with worsening psychiatric symptoms. And if you look at it, histamine actually crosses, it follows a circadian rhythm. So it's a little bit typically worse in the morning. And then later in the evening, histamine is also an excitatory neurotransmitter. So people don't think of it like that. And so you'll see like all these mood changes, increased anxiety. And for many of those patients, I might just say, hey, get on antihistamine or, you know, natural ones would be things like quercetin stinging nettles um and so that will actually help because they become less inflamed so you'll see like when someone is having

i when i put them on an antihistamine during that time and some general anti-inflammatories everything kind of cools out so that's also like looking at things like that or mold environmental factors mold suppresses the immune function, increases epistamine, it causes brain fog and focus, it can cause mood changes. So there are so many pieces. I also had Babesia like you. So I'm laughing when you were speaking because I'm like, I've had all of those two, Lyme, Babesia. And Babesia is one as well as Bartonella that affects the neurological system. So with some systems. So at that time when I had it, when I was in school, I was like completely drenched. I actually was wearing, I didn't even realize for like a year and a half, like all dark

colors because I would be completely soaked, but it was on one side. And so I was told what a lot of my patients are told and the patients that you've seen is, is it's in your head. You're just anxious. And I was like, but I'm having this happen when I'm just going to the grocery store and things where I'm not actually, you should be anxious or stressed out. And so that's the story. Although the grocery store can be anxiety producing.

And then you start having more. So that was the one thing that when I first started working with patients and also learning about Lyme disease, that a lot of them see about at least seven to nine doctors or many of the patients that come to see functional medicine providers before they actually get treated and diagnosed. And so I was one of them dealing with these symptoms that especially with women in particular will get kind of written off of you have a lot going on, you have a lot on your plate, which we do. But what else could it be besides just pure stress and anxiety? Yeah. And it's sometimes important to dig. And it's not like everybody with depression is the same cause or everybody with ADD is the same cause. And we label people and then we think they're all the same.

You have depression, anxiety, ADD, bipolar, OCD, whatever it is, schizophrenia. These are just labels that have nothing to do with the underlying root cause, which can be many things, right? And so you mentioned a lot of them in your talk around infections. We talked about toxins, poor stress trauma um and and uh even aging itself and it can actually drive inflammation in the body so all these things can be actually tested for and diagnosed and treated and what kinds of clinical um outcomes are you seeing when you start to treat a patient maybe you can share some cases so sort of make it more real for people because i think

it's abstract a little bit i mean okay, okay, inflammation. And we'll talk about what inflammation does to the brain. Maybe we could just share a little bit about the cases that you think are relevant to illustrate this connection. Yes. I've definitely had patients where they're, especially my patients with autoimmune conditions like rheumatoid arthritis, and they've gotten sick or an infection like COVID. And you'll see their CRP levels go up high, their ferritin levels go up, which can go up as an acute inflammatory response. And with that, you'll see like rheumatoid factor increase significantly. Or they got another infection, like I mentioned, like Lyme disease. And all of a sudden, their ANA or their titers will go up.

So I've had many patients where we've worked with, you know, like that situation where when we've worked on the inflammation, when we've worked on the infections, I'll actually see it where their antibodies like are no longer positive, where rheumatoid factor is no longer showing or the ANA is like at 140 versus like 1260, which is a marker for autoimmune condition. So what you'll see is like, and that's often something in conventional medicine, they'll say that's going to be the same for the rest of your life, right? You don't ever check. Yeah, you don't recheck. Like, yeah, like you'll see, you'll see like Hashimoto's and their number is 500. And they're like, well, it's always going to be positive. Well, then why did I get my patient to go below a hundred? There was something we were working on that was causing triggering of inflammation. So we started testing our office because people were coming back during COVID with like, wait, I just treated. You've been well. I haven't seen you in a long time.

All of the same symptoms were getting like reactivated. Like I remember one of my patients had Lyme disease, completely fine, hadn't seen for a year and a half after COVID had, you know, Bell's palsy, all of the symptoms they had from like a year and a half or two years ago. And so we just had to put them either either back on the protocol as well as like immune modulation. You could just see the numbers all cleared out. So I, I, I'm looking at it as a, um, what are the things that are triggering up inflammation, which are making these things that are like underlying actually get worse. And, and then, um, looking at that and its entirety and making sure, cause you can also go down one rabbit hole, like making sure you don't even in the space and making sure, because you can also go down one rabbit hole, like making sure you don't, even in the space of functional medicine, you're looking at

not everything's Lyme, not everything's mold, not everything. Yeah. Like how are you making sure to be open to other causes? Because I've even had one of my interesting cases, a patient with RA wasn't treated. It didn't get worked up for tick-borne diseases, worked on that, RA got better, was well, hadn't seen for a period of time. And all of a sudden, all the symptoms came back. And my question to her was, what happened? What's changed in your life? What has happened? And sure enough, it was a loss of a family member, but that person didn't connect that that would cause inflammation. And so my recommendation was, well, I'm not going to recommend anything. You need to see a therapist. And sure enough, the person after a month had said, they reached out

and said, Dr. Patterson, I don't know if it's just me, but like all of my symptoms are gone. And so I'm like, yes, stress and something like that can actually completely trigger up all of those symptoms you had before. But there's this kind of disconnection between that we don't really pay as much respect as we have on stress and inflammation, how cortisol, how that actually can impact the whole inflammatory response as well. Yeah, I mean, I think that's a really important point because stress either exacerbates or causes like 95% of all illnesses. And whatever's going on, it's gonna magnify it and increase your inflammatory state. Exactly.

Now, eating well is a critical part of reaching my health goals, but something as simple as getting to the store can be a challenge with my schedule. And that's why Thrive Market is my go-to for all of my organic grocery and household essentials. The convenience of getting it all quickly shipped to my doorstep is a huge time-saver,

and it helps keep me from just grabbing whatever's fast, which usually means bad for you. I especially love stocking up on snacks from Thrive Market. Some of my favorite include Chomps free-range turkey sticks, Hugh Mint chocolate snacking gems, Gimme organic olive oil and seaweed snacks, and their private label pitted green olives, which are so yummy.

And they even have a price match guarantee so you know you're getting the best prices on your favorite brands. You can join Thrive Market with my exclusive offer and get 30% off your first order plus a free $60 gift. Head over to thrivemarket.com forward slash Hyman today. Plus orders over $49 are shipped free and delivered with carbon neutral shipping from

their zero waste warehouses. That's thrivemarket.com forward slash hyman. Hey everyone, Dr. Mark here. You've probably heard of omega-3 fatty acids, maybe even omega-6. These are essential fats we need for health and longevity. But science has recently discovered a third essential fat and one with three times the cellular benefits as omega-3s. I'm talking about pentadecanoic acid or C15-0. There's mounting evidence that can help us repair and replenish our cells, strengthen cell membranes, and ultimately reverse the multiple drivers of aging. If you're looking for a way to take advantage of C15 yourself, fatty 15 has harnessed that power to

reverse 36 clinically relevant and aging associated changes at the cellular level. Fatty 15 does this by acting as armor for your cells, strengthening cell membranes for an 80% improvement in cellular stability. I like fatty 15 and I've noticed a big improvement in my joint health. My glucose levels are better than ever. Just one tiny pill a day will have a big impact on your health. So why wait? Age on your own terms with Fatty 15. Right now, Fatty 15 is offering listeners an exclusive 10% off a 90-day starter kit of their award-winning science-backed C15.

Just visit fatty15.com and use the code DRHEIMAN10. That's F-A-T-T-Y 15.com. And now, let's get back to this week's episode of The Doctor's Pharmacy. And in your talk, you really went deep into understanding how neurotransmitters, the brain messenger chemicals, get dysregulated by various insults. And all the things we talked about, poor diet, stress, toxins, allergens, gut microbiome, infections, viral infections, Lyme disease, whatever, right?

There's a common mechanisms that those all result in that drive an inflammatory state in the brain. And you mentioned looking at some of the biomarkers like IL-6 and C-reactive protein. And these are tests we can do through regular laboratory tests, which by the way, I don't get checked very often by my doctor.

But you talk about actually when this state of inflammation is going on in the brain, what's actually happening? How do neurotransmitters get affected? What's happening with the brain that causes all these psychiatric symptoms? So you'll actually see altering of, for example, NMDA receptors being impacted, which can cause that issue with glutamate. And then there's this altered, you should have an altered balance of, for example, GABA, which is more relaxing, an inhibitory neurotransmitter versus glutamate, which is triggering. So if you're having those ratios change, you're going more into a state that's excitatory, which is going to cause anxiety, depression.

You'll also see some of those protective cytokines like IL-10, which are going to help with inflammation, will go down because you're going to have more of the pro-inflammation. And that is actually one of the big factors feeding into things like dopamine, which make you feel good. And dopamine is one of the ones that can go lower for somebody that's depressed. And when you're inflamed, your dopamine is lower. Exactly. It'll go lower as those inflammatory markers increase up. So it shifts the whole balance. So we need a little bit of each one. So it's not, I always tell people, it's like, we do want a little bit, we do want some glutamate, we want those things, but it's what that balances. And what happens is with inflammation, it changes not only causing the direct damage to the area of the body, but also changing that, the neurotransmitter, the ratios, which will put you more in a state that is going to be

more imbalanced. Yeah. Yeah. I think that's right. And I think we end up causing trouble with the overproduction of excitatory neurotransmitters that stimulate pathways, like you mentioned, or the lack of neurotransmitters that help us with mood like dopamine or serotonin, right? And one of the tests we do in functional medicine is called an organic acid urine test, which seems like a crazy thing to do is check your urine if you're having psychiatric issues. But in my patients is one of the most important tests that I do. And it's something we used to do only for people with inherited metabolic disorders. And you can get it a lot, but it's really about the more subtle changes that occur in the biomarkers that relate to what's going on in your body. And one of the things we see is an increase

in kynuric acid, which is a sort of a marker of a pathway that increases up in terms of inflammation and is also a marker looked at when we're looking at neuroinflammation. And it changes tryptophan, and these are all precursors for things like serotonin. So kynuric acid pathway is also a marker of concern when it comes to neuroinflammation. Yeah, so you can see that is also a marker of, uh, concern when it comes to neuroinflammation. So you can see like a, that's sort of a sign of B6 functional deficiency. And that is B6 is required to convert tryptophan from your diet into 5-hydroxy tryptophan in serotonin. And then when that's not working or when there's inflammation, it also blocks an enzyme.

Can you talk about that enzyme, the IDO enzyme? Yeah. So, so it blocks the enzyme that's going to help with, it's causing more of the increased metabolism to, like you said, in terms of the 5-HIA, in terms of serotonin. So it's going to impact that pathway directly, which is going to be increasing up inflammation, but then again, the ones that are helping with things like anxiety are now getting blunted or impacted negatively where it's actually interfering with the production of it. And one of the biomarkers we see on the organic acids is quinolinic acid. A lot of big words I

know out there, but this is a biomarker you can check in your urine that indicates that the serotonin is getting shunted down a different pathway, which then leads to more anxiety, more depression, and you're getting this byproduct, which is highly inflammatory in and of itself. And it's a toxic kind of metabolite in the brain. And you can see it in the urine. And I can tell when my patients' brains are inflamed, they have high levels of this, whether it's a neurodegenerative disease, whether it's ADD or autism or depression. And so we can start to understand the biochemistry of this and the neurobiology of this in ways that allow us to actually directly intervene with therapies that can fix these problems. Exactly. And the chironerian pathway is kind

of the precursor to all of those ones that you just discussed. And so also the great thing with the OAT test, which you mentioned, there's also a section that tests for catecholamines. And those are all connected with norepinephrine, epinephrine. It checks for like HVA and all of those pieces in terms of your dopamine. And also even like fatty acid metabolism because we know fatty acids help to drop down CRP, which we're talking about with inflammation. And so if you don't have a good balance of omega-3, omega-6, omega-9, you're going to be, again, more pro-inflammate, you know, pro-inflamed, which also is going to negatively impact your mental state. So, and your physical body, obviously, but there's been tons of studies on just omegas as well, just for the mental health. And part of it is that down regulation of decreasing of the CRP levels.

So, you know, one of the things that I have been reading about, which I find fascinating, and it sort of kind of comports with what we're seeing in our society, which is this increase in dysregulated social behavior, right? Aggression, divisiveness, friends can't talk to each other anymore, families are breaking up over political issues. There's just whatever's going on. There's just, whatever's going on, there's just something happening where our social cohesion is breaking down. I mean, I think most Americans are pretty middle of the road and are not on the extremes, but the extremes are what

we see and hear about. But there is still a level of real divisiveness in our society and a real level of like increased in aggression and school shootings and violence and now so I mean we see it every day and I become almost immune to these stories which you know if you ever had had one it would have been a big deal uh and we didn't have this when I was growing up it wasn't like every day or every week there's there's a new shooting in some school and and the the level of of just the oppositional behavior and anger and hostility. And I mean, it's like I have a social media account. I just like sometimes I put stuff up that's sort of benign,

and it gets like a litany of hatred. And I'm like, what is going on out there? And why are people acting like this? And part of it is they can hide behind their social media handle or whatever. But I do think there's something fundamental happening to the brain. And I mentioned this before in the podcast, but when I was writing my book about the food system and the way our food was affecting us, I wrote a lot about the social aspects of it. And particularly, so studies that I came across around prisoners who, when fed a healthy diet, would decrease their violent crime in prisons by 56%. And adding a multivitamin reduced it by 80%. And in juvenile detention centers, when kids were fed healthy diets versus the crap that they were eating,

the violent crime went down by 97%. The risk of restraints went down by 75%. Suicide, which you mentioned, went down 100% in an age group of teenage boys, which is the third leading cause of death. And that's just simply cleaning up the diet, which is moving them from an inflammatory to an anti-inflammatory diet. So I have this theory, which is that a lot of our social disruption right now is really related to some level of neuroinflammation. And when I was reviewing your work, you were talking a lot about what happens to the adult in the room, which is sort of the person that knows we shouldn't go punch somebody in the nose, right? That's in charge. The adult in the room gets disconnected from the ancient

limbic reptile brain. And there's this weird disconnection that happens for the adult is gone. And so it's like we call it the amygdala hijack, which is a hijack of our behavior and our thoughts by this ancient part of our brain, which is all about survival, fight or flight, right? So can you talk about the science around this phenomena that we're seeing around neuroinflammation affecting the connection between the kind of grown up, mature person who's supposed to know how to conduct themselves socially and in life with the ancient part of our brain that just, you know just would kill anybody or do stupid shit. So what is the science behind that?

Can you unpack that? And also the trauma. When you look at kids, they said have shown the trauma from all these events that you were talking about. There's just long-term, we don't even know yet, longer-term issues with things like anxiety and depression as a result of the trauma that's happening during that time. Yeah, there's epigenetic. Exactly. There's complete changes.

So we have what's called the prefrontal cortex that develops for kids up until 26 years of age. We have what's called the amygdala. That's why the car rental companies don't rent cars to anybody over under 25. Because of that reason. Because they know their brain's not fully developed. The grown up in the room That's why the car rental companies don't rent cars to anybody over under 25. Because of that reason. Because they know their brain's not fully developed. The grown-up in the room is not in the car. Is not actually going to be the one driving, right?

Yeah. So we have the hippocampus, which is like for memory. And those actually both take a hit for anxiety and depression, which makes sense. Because you look when somebody has significant depression or anxiety, you'll see a lot of memory issues, like flightiness for people with anxiety, brain fog, forgetfulness. Yeah. We even call it pseudodementia. People get older, they get pseudodementia and depression.

Exactly. And actually, even the risk of dementia is up higher for people with mental health issues as well, likely because of the neuroinflammation. So you'll see those areas. Amygdala is more connected with like anxiety and that's what controls emotions and that piece with like the nine-year-old driving the bus versus, you know, the adult driving the bus. And so if you're constantly getting taxed with that and everyday day-to-day trauma, that is going to be more dysregulated. I mean,

they've had studies that show women passing, like in terms of being anxious during pregnancy having an impact on their their their babies that are born of the baby the child having more anxiety and things like that so the development of the uh the the prefrontal cortex which is like impulse impulses can develop up until 26 years of age other areas of the brain that get affected amygdala like i mentioned um hippocampus and other centers that help to regulate our emotions. So if there's constant inflammation on those areas or constant stress, which causes a dysregulation of cortisol levels, those could potentially impact those long-term too as well.

So do you think, like my theory is right, that a lot of the social discord is happening as a result of brain inflammation that's caused by all the factors we talked about? Yeah, I mean, they have tons of studies on technology's impact on dopamine and that every time you have like a hit, like even a ring on your cell phone or, you know,

like when you get your text, you get a dopamine hit for that. So one of the pieces is the more and more you have it, the more of a resort, like you're having less, your body's constantly needed to push out dopamine for everything with technology. One example I had, it was great. Cause I did a urinary test and, um, I was trying to get the person. I was actually working with someone that I didn't know was a big gamer.

And so, um, we did the test and at the evening the cortisol was like was the same that you would have in the morning to wake up because your cortisol should be higher in the morning to wake up low at night and then i said what were you and i knew right away i'm like were you playing like video games and she looked and was like how did how did you know i'm like this number there's just a lot of like hyperactivity or dopamine levels were high norepinephrine epinephrine cortisol was through the roof so of course she's gonna have sleep issues which she was having so you'll see that too I mean a lot of young people that are also in technology they're staying up till late at night as you know and it interrupts

their sleep and if they're not getting good quality sleep of course they're not gonna be able to focus in class of course they're not gonna be able to focus in class. Of course they're not gonna be able to emotionally regulate as well. So all of those things have these kind of added effects that can cause issues. But definitely technology with dopamine and as much as the parent can work with

reducing it in small bits. I don't try to say stop completely. I say let's cut 15 minutes at a time so it doesn't seem as significant. But that's what the great thing about tests are because you can actually see and show and demonstrate. And then it's easier to get people to say, oh, okay, this is why. It's true. I mean, I had a nephew who was a super addicted gamer and just didn't have a life other than gaming. And long story short, he lived with me for a while, and I took it all away.

I literally just hid it. And it was literally like watching someone go through heroin withdrawal. He went ballistic. And I was like, wow, this is like a highly addictive thing. So I think that, and he had ADHD, and it just made it worse. It made it a lot worse. And I think that, and he had ADHD and it just made it worse, made it a lot worse.

And I think we have this incredible moment happening in the field of psychiatry where we're beginning to understand the brain in mental health, not just the mind. And talk therapy can be helpful. Sometimes psychiatric medication can be helpful, but it's a pretty limited tool set. And now we have a whole new set of tools. So when you see someone come in, and they could have anything, right? Anything from schizophrenia to bipolar disease to depression, there's a process you go through to try to figure things out. Because depression is not a Prozac deficiency, right? Exactly. And, you know, it's kind of how we treat it, right? I call it the naming, blaming, and taming game.

This came from my mentor, Sid Baker. He says we name the disease by the symptoms, and then we blame the name for the cause, and then we tame it with a drug. So we say, oh, the reason you're hopeless and helpless and have no interest in life and can't sleep and have no interest in sex and don't have an appetite and you feel sad and you want to cry all the time

is because you're depressed depressed that's what's causing your symptoms well no that's just a name that we give to people who share those symptoms the cause could be you're eating gluten and that's causing brain inflammation or you had a been having a bad diet and had reflux because you eat too many fried foods and end up on an acid blocker for 10 years which depletes your b12 and zinc and magnesium or because you maybe have no vitamin D and that causes depression. And you're looking to see like, where does it land? I always say that for autoimmune conditions, it's like, to me, it's all the same thing. There's different names,

right? You know, but it's like, where does it, I say like land. And then that's why people have like three autoimmune conditions. And I'm like, is it really three different ones or is their system just attacking itself and it's finding their weakness yeah right like uh it's like aspen trees you know like they all look like separate trees but they're all one underneath exactly still the same and so that's kind of how most diseases are they're not comorbidities or not things that just happen to be randomly showing up i'm like you know this this you know kid that i was mentioned before at add had like 12 different diagnoses like and was on seven different medications and was seeing five or six or different specialists and and no one asked how are all these things connected like

when did it start and how did it start and things like that you know the beauty is then we can start to actually think differently about how to approach these problems and start to think about the common root causes and how to, one, do the diagnostic evaluation, which can pick a lot of these things up, and also the treatment strategies. And it can be something simple, like I mentioned with depression. I mean, it can be a B vitamin deficiency. I was writing my book and I think I was talking to somebody on the phone about it, whatever. And he heard me over talking. It was like I was fixing my TV in my office and he had to happen to be working when he was there.

And he's like, oh yeah, I was listening to what you're saying. And I was really severely depressed. And then I took these B vitamins, like B6, folate, B12, and it went away. And actually methylfolate or Deplin is actually a prescription drug, quote drug, which is an activated form of folate that psychiatrists use for treating depression. Yes, yes. But it's all like kind of this like one thing at a time.

It's like still the drug model. It's not really a holistic view of the body as a system. So when someone comes to you, see you, and they're suffering from whether it's depression or whether it's more PTSD or maybe they're having some psychotic kind of borderline issues or bipolar, where do you start? And then how do you kind of find the things that are driving the problem? And then what are the sort of steps you take to help resolve that? I think my most important thing is to also meet people like where they're at. So initially, I'm trying to do extensive. I just want people to do

what I want to do. I know how to get you better. Do what I say. You don't get to choose. That would make life a lot easier, right? I'm pretty actually convincing because I said,

look, let's try this for 10 days. That's what I say. I'm like, let's try removing this food for a week and see how you feel. And then people come back and they're like, oh, yeah, it worked. So I think the one thing when people see like naturopathic doctors, functional medicine doctors, they're going to get tons of lab work done initially.

That's always really important to me in the assessment because I'm going to look at environmental factors like I mentioned, like metal, lead. You mentioned when you were saying about juvenile delinquency of like changing food there's studies that even show there's a higher rates of schizophrenia after the age of 14 being aren't skits are actually juvenile delinquency and schizophrenia if they've drink drink from like private well water and poor water so even when you're going talking about food it's like what is the quality of their water what is their environment by way of pollution? I've had children that we've had... You've got some parasites who... Exactly. Even parasites where they've had ADHD and then they found that there was a lot of mold in their bedroom and they removed that and all the kids' symptoms were gone. Or I've had even

adults that were exhausted. And then when I did the assessment, I find out they drink four ounces of water and I'm like, okay, if you try to drink water and they come back, they're like, I feel completely new. Like how's your body eliminating toxins? So that's what I said at meeting people or the app, because there could be just basic things that people aren't even aware of. But typically with assessment, it's going to include like their metals. It's going to include things like you said, like, Oh, tests, I'm going to look at other infections, organic acid tests. I'm going to look at, and especially if someone's like, uh,

that rule of like ever since of like I got sick at this time. And then ever since then, this happened for women a lot of times hormones. So like after they have a baby, after they have a kid, you'll see those hormones drop down, which hormones actually are like estrogen can be if it's in a high amount, more pro-inflammatory and testosterone, more anti-inflammatory. So you'll see when there's a shift of that or, um, the cycle or perimenopause autoimmune conditions will go up too. So I'm looking to see like what that pattern is of like when it actually became dysregulated and, and getting as much like laboratory assessment, but like really having deep in-depth conversations of their story.

Cause you can, you can, oh yeah, I was fine until i moved to that house exactly tell me about that house well you know it was okay but it was a little damp basement or had like i think we had mold in the bathroom or something and you get you get these clues and i think you know in traditional medicine we sort of ignore most of those clues like you know your psychiatrist didn't ask about mold or how much tuna you ate or or were you. Or were you inflamed? Yeah. No, it's true. And I think you mentioned lab testing. I co-founded a company called Function Health, and we do a full panel of lab testing.

And we look at a lot of things that do affect psychiatric health, from your nutritional levels of vitamin D, of evaluation of the B vitamins through homocysteine and methylmalonic acid, which are ways of looking at B12, folate, and B6. We look at red cell magnesium. We look at zinc. We look at also other factors like metabolic health, insulin resistance, which can affect depression. Look at sex hormones can affect mood.

We look at heavy metals. So we got to really, and we look at inflammation. You know, I don't know if it's mind-blowing to me, but our population we've done uh five million biomarkers on over 40 000 people and 46 percent have high crps 30 30 percent have high ana 67 percent have a nutritional deficiency whether it's iron like you mentioned or homocysteine problems or the magnesium or omega threes we look at all these things as part of a fundamental panel to see what's going on. And it's amazing. If you start to fix these things, people get better.

And sometimes you have to go deeper, right? It's not just always just cleaning up your diet and eliminating inflammatory foods and adding a number of nutrients that may be helpful for your brain or are nutrient deficient. And it may also be like, okay, well, I got to deal with the heavy metals, or I got to deal with Lyme disease, or I got to deal with Babesia, or I got to deal with mold. And those are things that we don't really deal with well with traditional medicine. But if you're seeing a functional medicine doctor, you know, they can see you in your practice in Connecticut. They can come to our center in Lenox, Massachusetts, the Ultra Wellness Center.

And we deal with all these chronic complex issues. And we deal with sort of the crises in mental health. And, you know, I did a documentary a documentary series years ago called The Broken Brain. And it's really about how most of our brains are not working properly. And we don't really have a great way to deal with brain disorders because our whole thinking has been completely wrong. And focus and – I mean, I have so many – I feel like over half of my patients, you ask about brain fog or focus.

It's like more than half of them have an issue. It's this like of the activity with their brain and managing everything that they're doing. patients you asked about brain fog or focus it's like more than half of them have an issue it's this like of the activity with their brain and managing everything that they're doing and rates of what adhd going up and anxiety is it truly that or is it you know we're just doing too much as you know as a society part of what i talked about in the presentation giving for ifm too were the other things outside of like even diet is like the benefits of like sauna and how that showed to decrease CRP levels. And also in studies that they did in Europe for men that there was like decreased chance

of like things like schizophrenia, forced bathing. That's crazy. Wait, we just want to stop there. You just said take a second sauna can help reduce psychiatric symptoms and even schizophrenia. Exactly. Schizophrenia. and even schizophrenia. Exactly. Schizophrenia. That's crazy. Yeah.

And this was a study of men at large for like decades. Yeah. And they showed that there were lower rates of things like schizophrenia. If you look at also it decreases CRP levels, which we keep talking about with inflammation. You also look at like forest bathing. There was a study in Japan to show that the CRP levels went down significantly with more forest bathing and lasted for a period of time. So these are all the things that you can get people to do in small steps that just shows there's that lack of connection. Like loneliness, I think is a huge factor. And that's one of the biggest things we're always trying to

work at in our office. Even with anxiety, they've shown the most effective is doing that with group therapy, like treatment plus therapy. I think it takes a community, but it's like you doing things to detach yourself from technology, like grounding, sauna, those things, but then also your community of people around you to be able to support you as well. Yeah, I think that's really important. And I think dealing with the things like exercise and social connection and detoxification, saunas, which regulate your autonomic nervous system, being in nature, these are all therapies, right? And they can be really effective. But sometimes people have real stuff going on that you can do all those things that it

may not completely get better. And I experienced that. I mean, I had a lot of brain issues when I had mercury poisoning. And that was my mid-30s. And I cognitively was so impaired. I couldn't focus, think, remember where I was at the end of a sentence. I went from listening to 30 patient stories a day and not taking any notes and being able to dictate all their charts and remember everything I did, to basically not really be able to barely which is scary especially

in your 30s yeah yeah and I and I and I could feel the the brain dysfunction and um and I've had mold toxicity and I've had Lyme disease and I think these things cause residual things and I and I'm like I'm always learning and I'm always learning and treating myself and experimenting and i i do pretty well i've written like you know 20 books in 20 years and do a lot of stuff but i still you know had i didn't feel like my brain was back to 100 and so i did i did a test which was actually from germany where they look at your cellular levels of toxins which is something that's hard to do because toxins are not in obviously for those listening easy to measure in the blood because they're often stored in the fat. And so we can measure the fatty membranes and what's in the cells.

And I have like mold toxins and pesticides and lots of heavy metals and a lot of dysfunctional pathways that are related to this and oxy of stress. Because I can feel myself like sometimes just boink out, like my brain would just hit the wall. And I knew it was physiological. And even with all the stuff I do, I wasn't able to sort of fully crack that. And I recently did a protocol, which has been around for a long time, but it's a modified version called the PK protocol, which you probably know about, which is essentially using to replace your cell membranes that are toxic with newer, healthy substrate for the membrane, which is phosphocholine. It's basically a kind of a fatty compound. And I did like a whole bunch of IVs of it. And I redid my test after, and I was like dramatically down on all the toxins. And my brain has come back online in a way that I didn't realize I was still affected, you know?

Yeah. That's one of my favorite ones, phosphatidylcholine, because it just protects the brain, but there's tons of studies on it for dementia and also for ADHD. I usually like the phospholipid blends with like phosphatidylsterine, which actually also helps regulate cortisol levels. So I'll oftentimes do it nighttime. I personally love to take,

because I wake up ready to go, like my brain is sharp and I'm ready to go. But it's, take, because I wake up ready to go, like my brain is sharp and I'm ready to go. But it's, yeah, because I think it drops the cortisol, but it also has that effect on your brain, your memory, supportive that people tend to feel better when they get up. Yeah. So what I meant to share with that story is that, you know, it's an ongoing process to figure out the levels at which we're all affected because you know we do live in a world with a lot of toxins we live in a world with a crappy diet we live in a world with a lot of stress we live in a world of things that destroy our microbiome we live in a world with where we have um things like mold or tick infections or latent infections long covid all of that there's a huge role in dysregulating our brain function uh so this is kind of really a

whole new era in in psychiatry um it's a whole renaissance going on our brain function. So this is kind of really a whole new era in psychiatry. There's a whole renaissance going on. I don't know if you saw, but there was a whole series of articles in The Economist recently, which is not a medical journal, but the whole thing was on psychiatry and the revolution in psychiatry and how maybe we should be looking in the body to fix the brain. And that was the subtitle of my book, How to Fix Your Broken Brain by Fixing Your Body First. Yeah, and I see a lot of openness now too in the psychiatric conventionally trained

of looking at the diet, the food, the lifestyle, and then also what those medications can have impacted by way of, we talked nutrient deficiencies or are there particular things, nutrients that are missing? So it's going to be, and as we see the rates of mental health issues continue to rise, there's got to be a lot more level of awareness of what are all the other causative factors besides just genetic. Yeah.

It's true. And then genes play a role, right? They can set up the stage. And I think maybe part of what we're seeing with the mental health crisis is partly epigenetic. So epigenetics, right, are the ways in which our genes are expressed or controlled. So can you share some of your understanding about how epigenetics might affect us? You mentioned kids born to women who are stressed, whether it was a Holocaust victim survivor or a 9-11 survivor who was pregnant at the time and their babies have all kinds of dysregulated stress response

receptors that are genes that get kind of switched on that are not good for us. Exactly. So can you talk about how that may be playing a role in terms of the sort of degradation of our mental health as a society and how the epigenetics might play a role in that? Yeah. And it definitely doesn't, even when you look at things like autoimmune conditions, there are multiple infections, especially with the genetic predisposition, family members with autoimmune conditions like myself, there's going to be a higher risk factor for having autoimmune

conditions. So I always say those genetic steps, those information shows you that that could be a possible concern for you, risk factor. But then the concern is like, then what do you actually do for that? Like, what are the things you're removing by way of, you know, being aware of, you know, um, plastics, being aware of like environmental exposures. Like what are the things, uh, for me, like my family, I have family history of, um, uh, autoimmune conditions, lupus, rheumatoid arthritis. For me, I know having infections might be problematic for turning something on, I'd say. So what are those things that we know potentially are risk factors? And then what do we do to help to augment what, you know, what it's connected with and how do we actually decrease it as much as we possibly

can? Yeah. And so, and there are, there's not just epigenetics, which is how genes are regulated, which is definitely affected by, for example, what happens to your mother in utero? Does she stress? Does she have a bad diet? Were there toxins exposure? All those things can affect. They get passed down.

And that can manifest later on in life in the child or even the grandkid. You're also talking about certain genes. So there are genes that do affect your risk of mental illness that we can test, that affect dopamine receptors, that affect cortisol receptors. Because everything in your body is made from your genes, right? All your receptors, all your tissues, all the proteins, that's what your genes do. And so when you have certain at-risk genes and you put them in the wrong environment, genes load the gun, in the wrong environment, genes

load the gun, but the environment pulls the trigger. Exactly. And there's tons of tests now that even test for neuroinflammation, like in terms of antibodies to particular markers that can cause inflammation in the brain too. So those are all going to be helpful risk factors to know, okay, I'm, you know, leaning towards this, what do I do to actually, actually help to support it fully? Yeah. So So what are the foundational principles of, you know, diet, lifestyle supplementation that can work for a lot of people? It's not, it's not going to be personalized, but I'd love to sort of just like,

what's your foundational sort of neuropsychiatric brain health approach? Okay. So typically, well, I'm always looking at what lifestyle things we can do. One of the things that's really important to me is like, I always say it's like, what brings you joy? So I think, yeah, what actually brings you joy? Because a lot of people stop doing those things. Oh yeah. Okay. Maybe I should do an ad disclaimer of what brings you doing that's healthy. So, so I find a lot of people stop doing like they love to dance or they love to hike and they stop doing all those things that, you know, that they have anxiety and depression. It's like, you need to do more of that. And so those things get lost because we live in a busy world. And so some of the thing in terms of approach is like how do I get people back to doing some of the things

they love to do before because then you're happier your neurotransmitters are better dopamine endorphins everything if you're doing something that you actively feel better so I look at that or that that you really that brings you joy vitamin J deficiency vitamin J exactly I like that so so we have that, then obviously exercise, but I try to get people just walking. There's tons of studies that show walking is just as effective if you're consistent. So I try to go in baby steps of looking at all those things. And then with food, really looking at things that are more like color, as many more plant-based foods that you can have as possible. I don't try to initially remove a lot of things because I don't initially,

maybe Dr. Hyman probably is stricter on that because first I try to get better. You've got to get rid of difficult, but I try to get them to do more, adopt better behaviors and then start removing those things that are like really bad. Let's remove one thing at a time. So I do that. And then when it, when I, I definitely do the lab assessment assessment and blood work but the other thing that's helpful is like things like amino acids um amino acid powder amino acid blends those are often the precursors to many of the neurotransmitters so we look at tyrosine which is um connected with dopamine nor and then the

pathway is dopamine norepinephrine epinephrine so i'll look at that i'll look at tryptophan so an amino acid as supplemental. Because if people think they're eating a protein, they're getting all the amino acids. But they're not oftentimes. And then especially kids, because they just don't eat as well, they might not get enough from their sources. So I'll often look at amino acids as kind of a beginning function.

I look at a lot of core minerals like magnesium, zinc, selenium. You do have to be careful with balancing zinc though and copper. And so I check for that too, because a lot of people just take zinc year round. And so you want to look at that because that can affect the mental state as well. So those are some of the initial things. And then oftentimes I'm looking at other things like adaptogens or things that can overlap. I mentioned turmeric. So I might use turmeric because they're also inflamed, but that also helps with depression. Ginger, I can incorporate that in their food.

Ginger is connected with helping with GABA, which we talked about earlier to help improve mood, but also ginger not only helps with digestion, it also helps with inflammation as well. So I always try to look as a practitioner you're working with, anybody's working with, are they looking at yeah there are things that we can also cover two or three things at the same time I'm looking at their gut microbiome oftentimes it will do a stool test and there tends to be issues with

that chronic does people chronic diseases have lower levels of things like lactobacillus and bifidobacterium and particular ones are more protective with anxiety and mental health issues. Raminis is one that's connected lactobacillus raminis, lactobacillus plantarum. So I'll look at those in a stool test, but I also try to, and you get that all from like fermented foods and eating well, but most of us can't get enough. So we might have to do things like a probiotic. So you really want to look at that whole piece, but then also going backwards to see like, when did it begin? Was it after they were sick, had a lot of digestive issues? Because you'll see increases of anxiety and depression also for people with IBDs. It's like much higher

with inflammatory bowel disorders, like ulcerative colitis and Crohn's. So again, if the rate is higher, then you have to think there is some relation to the gut. Yeah, the gut and mental health. You're not depressed because you have IBD, but you're... The other way, yeah. The other way around. The gut depression, yeah. I think that's true.

Even irritable bowel, I remember reading a paper years ago, I think it was in New England Journal, where they talked about the rethinking of psychiatric illness that was related to irritable bowel. We just think that people, when I went to medical school, it was like, if you have irritable bowel, it's because it's all in your head. It's not a real disease. Yeah, it's not a real disease. And you're just anxious and stressed. So take a little Valium.

And we used to give this stuff called Librium, which is like basically Valium. And it turns out that it's the abnormal bacteria and the leaky gut and the inflammation that's feeding back to the brain from the gut imbalances of the bacteria and the leaky gut that's driving the brain inflammation. It's probably one of the biggest factors. Exactly. Yeah. And they also regulate some of the bacteria, like I mentioned, lactobacillus rhaminis is also helping with things like GABA and those.

And so there's definitely a huge connection there. And most individuals with either chronic disease conditions or mental health conditions will have an impact 100% on their gut microbiome. And we talk a lot about probiotics, but now there's a whole field of psychobiotics, which are probiotics that affect brain health. That are more particular, yes. And they've been studied with mice and such. Yeah, can you talk about this whole field of psychobiotics? Yes.

Is it legit? Yeah, there's definitely been studies. Raminis and Plantarum are two of the ones that have been studied where they had done studies with mice and they actually for depression too and anxiety. I don't know exactly how they decided what qualified for depressed mice. Oh, well, I'm sure. They're sitting in their corner and they don't eat. And so basically they exchanged that bacteria just like how they were doing with the fecal microbiota transplants. And they found that those mice were actually like not depressed or not anxious, but then the ones that they gave it to were more anxious or depressed. So there is definitely some subspecies, different strains that have been studied to help with mental health state as well that actually can

potentially improve it. Yeah. And you talk a lot about the, you know, the sort of, even in schizophrenia, how there's psychosis. And I think, you know, we don't think of, wow, autism or psychosis being connected to gut bacteria, but it often can be. I remember I had a kid with autism, it was pretty severe autism. And we looked at a stool test and he had giardia oh wow which is a you know pretty significant parasite that causes malabsorption and nutritional deficiencies and inflammation and and i basically just treat it as parasite with a drug flagyl and the kids autism got it better wow that was crazy that doesn't mean all kids with autism have this thing. These are just common ways the body has to say ouch.

There's not that many ways the body has to say ouch, right? Depression, anxiety, psychosis, ADD. These are things that there's a pretty finite set of problems that can occur, but from a very almost infinite variety of different reasons. And so that's why psychiatry has to really shift. And I think one of the fields that's really emerging around this is metabolic psychiatry and mitochondrial health and psychiatry. And Suzanne Goh has been on the podcast, talked a lot about the role of mitochondria and autism and a lot of mitochondrial deficiency and the dysfunction in these kids.

Chris Palmer has been on the podcast, also talked about, from his book Brain Energy, their role in poor metabolic health, is actually using ketogenic diets to treat mental health issues. So I wonder what your perspective is on that. And he's using it for schizophrenia, bipolar disease. What's your perspective on that? They have had studies. I saw ketogenic and more so for actually schizophrenia

in terms of ketogenic diet being more, uh, supportive for that because of the, the body fueling, um, basically, especially with the mitochondria piece that you, that you mentioned in the right way. There's also, it's called like the mind diet is another one that's very similar to Mediterranean diet probably has the most studies for mental health. Um, and it includes like when you look at Mediterranean, more like higher levels of acromantia, which is one that now has been shown for like cognitive support and tons of benefits of that particular strain.

So- And acromantia produces GABA. Exactly. So basically like you don't have to take a neurotransmitter supplement, you take a probiotic or you feed that probiotic with polyphenols and then you'll get'll get naturally occurring beneficial oh gaba yes and then when i often test people they're often deficient in like acromantia or they don't have enough lactobacillus and all those things that are actually protective for them uh so we look to you know see how we're we're actually gonna like fully augment that and then how do we get to the state where they're managing it as much as they can through diet and we don't have to do as

much by supplementation. Yeah. I mean, it's just an extraordinary moment to be in this field of psychiatry. Um, any, any other exciting stories you want to share about some cases that they've got better from using? Yeah, I think, um, the, I tend to work with a lot of children with PANS and PANDAS and also that have kind of coupled with like ADHD, et cetera. And so it's just been, you know, many patients where the parent, when a child has PANS or PANDAS, what happens is there's an acuity of symptoms. So overnight, the parent, I remember one of my first cases, the parent said, my daughter went in to go take a shower and she came back and she was a different kid. They start getting scared of eating, that they're going to choke on their food. They start having a lot of issues at nighttime, OCD, significant anxiety, and even getting pulled out of school. So my reward is to be able to see now having these children within like a few months being able to get them back, you know, to school.

Or I've had kids that have been like out of college for a year because of their illness with, you know, tick-borne diseases. And now they're like, they're fully back. And one kid I just saw the other day, she's going into a nursing program. And I'm like, wow, that's amazing to see. And these are individuals that would have fallen through the cracks and just told to get on psychiatric med and may have tried it. And they haven't changed. So I get a lot of stories, especially with the parent, because overnight it changes the whole family dynamic.

Yeah, I mean, the kids respond so well, too. It's quite amazing. I mean, grownups are a little harder, but kids are like, very fast. Yeah, kids, it's instant. It's really amazing. They have a basic overall healthy sort of well, too. It's quite amazing. I mean, grown-ups are a little harder, but kids... Yeah, kids, it's instant. It's really amazing. Very fast, yeah. They have a basic overall healthy sort of substrate, basically. It reminded me of a kid I had with PANDAS, which is this pediatric-associated neuroinflammatory

disease that causes OCD and horrible behaviors in these kids. Tics, potentially. Tics, and really scary for the parents. And this kid had positive strep antibodies and inflammation. And I said, well, geez, you can't just throw antibiotics at it because it may not really work. But actually, I recommended intravenous ozone for this kid, which is kind of a little out of left field. But I really understood the role of ozone in decreasing inflammation and being a powerful germicide. And this kid completely got better.

And it was amazing. And for good. So I think there's so many people suffering out there with a whole array of mental health issues, whether it's just sort of low-grade depression or anxiety or more severe depression or more severe mental illnesses like bipolar disease or OCD or pandas or autism or schizophrenia or psychosis or a whole range of things that

now we're sort of beginning to finally understand. And I think we're getting closer to what the truth is. I agree. Even like infections that, you know, controversial, like after COVID, it's like, oh, you can still have long-term symptoms. Because with Lyme disease, for example, it was told after you got antibiotics, you're good to go. But when you look at it, there's what's called post-treatment Lyme disease, about up to 30% can continue to have symptoms, especially like arthritic and joint pain and those types of symptoms. So I think there's now become greater awareness of like, oh, these little micro assaults or infections can cause different areas of impact on the body, including mental health issues.

Well, I mean, you're such a pioneer. You're doing such great work in this field. I think people need to know more about your work. They can find you on your website, womeninlyme.com. Yes, womeninlyme.com. My practice is Fairfield Family Health in Connecticut. And we're also having a summit shortly. It's called Lyime Heal Hers. And the reason we did that was because one of the things that's important to me was to have

represented different faces. And we wanted to have it where it was all women because they never do that for events. So we did a whole lineup of different topics. So check that out because we're having another summit in August. So I would definitely look at that as well. And you also have a book, Women in Lime. Yes, Women in Lime. I have a couple books, Women in Lime. And then the other one was on long COVID and what to do. It's actually a great book because it's a small, short book that I did with another doctor in my office, Dr. Medea.

And so that's a great one. And I'm pretty active on Instagram, naturopathic.physician, where I try to post out information too. Well, thank you so much for what you do, Dr. Patterson. This has been an amazing conversation. I hope it's been helpful for people listening because people are struggling out there. I mean, mental health is, you know, obesity and mental health are the two biggest things facing us. And they're, by the way, they're not unrelated.

So I'm excited to keep learning from you and I hope everybody checks out your work and keep up the good work. Thanks so much for having me. Great discussion. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts.

And follow me on all social media channels at DrMarkHyman. And we'll see you next time on The Doctor's Pharmacy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more. And now you can have access to all of this information by signing up for my free Mark's Picks newsletter at drhyman.com forward slash Mark's Picks. I promise I'll only email you once a week on Fridays, and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey, and I hope they'll help you too. Again, that's drhyman.com forward slash Mark's Picks. Thank you again, and we'll see you next time on The Doctor's Pharmacy. This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland Clinic and Function Health, where I'm

the Chief Medical Officer. This podcast represents my opinions and my guests' opinions, and neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com.

If you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible.