Functional Medicine Psychiatry – Getting to the Root Cause of Mental Illness - Transcript

Dr. Mark Hyman: Coming up on this episode of the doctor's pharmacy.

Dr. James Greenblatt: Between the environmental toxins between the malnutrition, the sugar, I believe the genetic vulnerability catching up with us, it's just a kinda perfect storm that has resulted in this mental health crisis. Although, you know, I always stress that I I'm tired of hearing the term, mental health crisis. Yeah. Because I I think the better term is for us, it's a crisis of care. It's the model.

Dr. James Greenblatt: Yeah. Because it is treatable. It's not just numbers going up.

Dr. Mark Hyman: Everybody. I think We all know that we have a mental health crisis, but we also know that our current approaches don't work. Things are getting bad and even worse than bad for many people. And we had an amazing conversation on the doctor's pharmacy podcast with Doctor James Greenblatt who's been studying functional psychiatry for 4 decades plus. And even in college, he was studying the vitamin B3 and mental health issues, and he's an expert in this.

Dr. Mark Hyman: And we go deep into how Our current understanding of mental health is completely wrong. And that we are not looking at the root causes, which include nutrition, toxins, or gut microbiome, and nutritional deficiencies and all sorts of other factors which aren't often looked at in traditional psychiatric care. So we talk deeply about issues like ADD and depression, anxiety, bipolar disease, schizophrenia, even things like Alzheimer's, and even eating disorders. So we get a really beautiful conversation about what will be the future of psychiatry for everybody, but you're not hearing about it from your psychiatrist So check out the podcast, learn more about Doctor Kingblatt's work. It's quite amazing, and that was a very profound conversation for me.

Dr. Mark Hyman: So I hope you like too, and I hope you enjoy it. We're gonna dive deep into the the work you've been doing for the last decades. What it means for us today and why it's so critical to rethink psychiatry. Great.

Dr. James Greenblatt: Thank you. I I have hundreds of hours of content that I've been teaching but I've really kinda boiled it down to to one sentence to help psychiatrists just what you alluded to. We have a neck. You know, what connects our brain and our body. And if our mental health professionals understood that Yeah.

Dr. James Greenblatt: Then we could kinda make inroads into understanding what's going on.

Dr. Mark Hyman: That's such an important point because years ago, like, maybe, almost 30 years ago, I started, you know, treating patients with functional medicine. And I was treating their gut or their autoimmune disease or their allergies or some nutritional deficiency or their blood sugar list goes on. Whatever I found, I would Correct. Which is what we do. We take out the best I put in the good stuff.

Dr. Mark Hyman: That's functional medicine, essentially, in a nutshell. But then I noticed all these other things were happening. The side effect where depression would go away. Panic attacks would go away. Bipolar disease would improve or go away.

Dr. Mark Hyman: People's autism would get better. Sometimes even go away. Because of the ADD would normalize. And I was like, Alzheimer's would reverse. I'm like, what the heck is going on here?

Dr. Mark Hyman: So I'd might jokingly call myself the accidental psychiatrist I wrote a book about it called the Ultramind solution, which essentially is about how we need to fix our broken brains by fixing our body first. And that's essentially what we do. So how did you kinda first kinda get the uh-huh? We were talking out back in college. You were studying with leading thinkers and psychiatry at the time, Doctor Abraham Hoffer, and orthimolecular psychiatry.

Dr. Mark Hyman: In fact, Lias Paulie, who won 2 Nobel Prizes, one for discovering the structure of protein, the other for the Nobel Peace Prize for the nuclear test ban treaty, he basing wrote this paper that started the whole field called Ortho molecular Psychiatry published in one of the leading science journals called science, and it was called Ortho Molecular Psychiatry. About correcting ortho means to straighten in molecular means molecules to straighten molecules to fix your your psychiatric issues. Right? So how did you kinda come into that? Really by accident in college, I just had wrote a paper on vitamin B3 and brain function.

Dr. Mark Hyman: And that's how I found ortho molecular medicine and Abraham Hoffer. So that was b mean,

Dr. James Greenblatt: I know I wanted to go to medical and no concept of thinking about psychiatry, but always interested in nutrition and brain function Yeah. Kinda carried that through. I got diverted for about 7 years where I went through psychiatry and child psychiatry and came out as a psychopharma colleges. Mhmm. But quickly realized why I went into medicine and, got back into

Dr. Mark Hyman: You joined the call for a minute. Joined the cult, and then you got out. Is that what I was saying? Practice.

Dr. James Greenblatt: You know, most of what I was seeing with kids with ADHD, and I just realized stimulants weren't the answer. And Yeah. Cut back to why I went to medical school.

Dr. Mark Hyman: Yeah. It's the same thing happened to me. You know, I got I was like, I got a family doctor. I sort of came in as a yoga teacher, studying nutrition, and, you know, really focused on fundamental lifestyle issues and diet and health. I mean, around these books, And, nutrition against disease that I read in college by, Roger Williams and changed my thinking about everything.

Dr. Mark Hyman: And I got into medicine and definitely got sucked into the into the black hole Right. And realized that she's after 4 or 5 years of doing this, I wasn't helping people. And the and I need to go back to the way I was thinking before. And and it was powerful. And in this in this view that you you you shifted your thinking, what What were the sort of fundamental root causes that you're finding that account for the magnitude of the mental health crisis we're seeing now?

Dr. Mark Hyman: And I and include mental health So I include ADD and autism and all these things, eating disorders, all of it.

Dr. James Greenblatt: Yeah. I mean, the challenge 30 years ago on the challenge today He's at it's complex. So everything you mentioned that you look at as a functional medicine doctor plays a role in in mental health. And then we throw in strong genetic vulnerability. We throw in stress and trauma.

Dr. James Greenblatt: And each patient, even though they have the same diagnosis, 10 kids with ADHD, we're looking at 10 different causes. So the only path to really finding a a personalized treatment plan is the objective testing.

Dr. Mark Hyman: Uh-huh. It's

Dr. James Greenblatt: just Doesn't happen in traditional psychiatry. It's just symptomatic based medicine, and you just, you know, throw the dice. Maybe it'll work. Maybe it won't.

Dr. Mark Hyman: Yeah. Mean, that's such an important point, because traditional psychiatric diagnosis is just based on describing symptoms. If you have these symptoms, It means you have this diagnosis. If you're have low energy, if you're sad and hopeless and helpless and you cry all the time and you don't wanna eat and you can't sleep and you have no issues in sex, Oh, you're depressed. That's what's wrong with you.

Dr. Mark Hyman: That's the cause of your symptoms. No. It's not the cause. It's just a name of those symptoms, not the cause. And so How do you navigate to the cause?

Dr. Mark Hyman: Take us through the thinking that you have when someone comes in with depression, let's say, How do you unpack that for them? Like you said, there's ten people with depression or a hundred people. They're all different. How do you begin to sort through the things that our root causes for these patients.

Dr. James Greenblatt: The first is is working with the individual utilizing. You mentioned Roger Williams, a concept of biochemical individuality. Everyone's different. So I think with patients hear that, they're hopeful and that we're gonna look objectively at what's going on. And so it's that functional medicine workup.

Dr. James Greenblatt: It's looking at hormones and minerals, and it's understanding the gut. So it's a it's a big objective laboratory workup to for step 1. And I think what's missed in the functional medicine community a lot is step 23. No. Because, yeah, you might get b 12 deficiency and you might get hypothyroidism.

Dr. James Greenblatt: Yeah. And they'll feel better. But guess what? They had 3 generations of depression, and there's something else going on biochemically. So there we need then add you know, the second and third layers.

Dr. James Greenblatt: And sometimes it's medicine, number 3, but there are also blight style changes or kind of nutraceuticals. Nutris that we can use at higher doses to affect behavior. So it's not just a pure functional medicine workout. It's functional plus.

Dr. Mark Hyman: Yeah. Totally. I mean, and I I I just think functional medicine is just a way of thinking, and it includes all of it. Includes pharmacology. It includes anything that works, whether it's trauma therapy or psilocybin, whatever.

Dr. Mark Hyman: Right. It it's finding the right treatment for the right person. And if someone's had a deep trauma, You know, it's not it doesn't just register in their psychology. It registers also in their biology. We know this from the childhood events score, the adverse childhood events score, the a score.

Dr. Mark Hyman: Is highly correlated with not just psychiatric issues, but also autoimmune disease, cancer, heart disease, diabetes, obesity, you name it. So the functional medicine perspective is really different because, you know, like you said, we unpack, like, the root causes diet, you know, exercise toxins, allergens, gut microbiome, nutritional biomarkers. And even looking at nutritional, factors in a in a in a very different way. It's looking at urinary metabolites, looking at various kinds of biochemistry that can tell us, for example, if there's inflammation in the brain, But we also look at genetics. You mentioned this sort of family history that people have of 3 generations.

Dr. Mark Hyman: And now there's a whole field of of nutritional and and metabolic psychiatric genetics so we can see what risk factors you have that predispose you, but that are modifiable. Right? So you're not doomed if everybody of him is depressed. There's stuff you can do about it.

Dr. James Greenblatt: Absolutely. Yeah. I mean, there's some clear genetic variance we know, like maybe an m t MTHFR gene, but the and as we get more detailed family history, oftentimes, we don't know the genes, but we know there are 3 generations of depression or anger, other mental illness. And it just kinda puts a perspective as to what the treatment model could be and where medications might or might not fit in.

Dr. Mark Hyman: So take us through sort of sort of a depression patient And and what what would be the things that you're gonna sort of start with? What are the things you're gonna look for? What are the common things that you're gonna find? Cause you say it could be anything a there's a great cartoon I often would use my lectures. It shows a a family doctor looking in somebody's ear and goes, it could be anything.

Dr. Mark Hyman: And then the caption is a way too general practitioner. Right? So there are but there are things that we know that play a big role. So maybe we consider start to share. What what are the common things you're seeing in in patients who have depression that are modifiable?

Dr. James Greenblatt: Sure. I mean, some of the nutritional deficiencies that are pretty common that any family doc could do would be vitamin b 12.

Dr. Mark Hyman: Yeah.

Dr. James Greenblatt: Indeed. And vitamin b 12 is a pet peeve of mine because our normal range Yeah. The lab slips might say 220 Yeah. 21100. And nobody feels well with a level of 2 20.

Dr. James Greenblatt: So there are times we've treated people with severe depression that were told by their PCP. They have normal B Twelve.

Dr. Mark Hyman: Right.

Dr. James Greenblatt: And a b 12 shot, and then they're on a different path. Yeah. So some simple nutritional deficiencies, and then we get into Got dysbiosis. So we look at organic acids. We look at trace minerals, hormones, and try to understand what's going on for that individual.

Dr. Mark Hyman: Oh. One of

Dr. James Greenblatt: the more common things that it's not commonly looked at, particularly for women I found is low levels of amino acids. Serum amino acids being low. Even though they're eating, they're perfect, you know, protein rich organic foods.

Dr. Mark Hyman: Why is that?

Dr. James Greenblatt: The lack of, hydrochloric acid.

Dr. Mark Hyman: And they're not absorbing.

Dr. James Greenblatt: And they're not just absorbing any of the protein, particularly women that have been through stress. Or trauma. So somehow their digestive system just kinda stopped at some point years before the depression, not producing acid, not absorbing amino acids. We do testing, and they're just deficient in every amino acid.

Dr. Mark Hyman: Alright.

Dr. James Greenblatt: And that's been common, particularly in women.

Dr. Mark Hyman: So you give them then what

Dr. James Greenblatt: one to just have enzymes with acid and just free form amino acids. They feel better in a week.

Dr. Mark Hyman: They do the specific ones, like tyrosine or phenylalanine or All the

Dr. James Greenblatt: essential amino acids. Or So initially, it would be all the essential amino acids. So, as a blend, And then sometimes we would increase with 5 HTP and phenylalanine.

Dr. Mark Hyman: So it's like a like a powder pre digested amino acids that then just gets absorbed easily without having to go through all process of breakdown.

Dr. James Greenblatt: Absolutely. Yeah. Yeah.

Dr. Mark Hyman: So you see sort of malnutrition and low nutrient levels, right, which play a role.

Dr. James Greenblatt: Again, regardless of diet, people are spending a lot of money eating these perfect, healthy foods, and you look at their tests and their malnourished

Dr. Mark Hyman: Yeah. And there's a lot of things that play a role Hyman mental, magnesium, zinc, omega, 3 fats, right, copper. Can you talk about some of those and how they play a role?

Dr. James Greenblatt: I mean, I think omega 3 is probably the most well researched and traumatic. I mean, it was researched from when we were in college. Logan omega 3 and depression, anxiety, and suicide risk. The military has actually fortified rations the US military, fortified rations with omega threes to decrease suicide, but it's still not standard practice. So we have more research on omega threes and brain health than any pharmaceutical.

Dr. James Greenblatt: Yeah. But it's not standard practice.

Dr. Mark Hyman: No. It's not just doesn't doesn't hit the radar when you walk in the psychiatry office.

Dr. James Greenblatt: It's kinda part of that.

Dr. Mark Hyman: Tell me about your mother.

Dr. James Greenblatt: I'll tell you this medicine. Right? It's still alternative, even though it's research. You mentioned the omega threes. The trace minerals magnesium is probably the most common deficiency, you know, and certainly anxiety, depression, ADHD, Insomnia.

Dr. James Greenblatt: Cuts across all major psychiatric illnesses. And and the zinc copper ratio most of the time, We see elevated copper in kids with hyperactivity, but in depression, sometimes we see very low copper. Yeah. So it's testing and then treating the objective test.

Dr. Mark Hyman: Yeah. I I heard a story from a patient once about their brother. I didn't treat them, but I and they're really being Europe. And the brother had schizophrenia. It was pretty bad.

Dr. Mark Hyman: And somehow he heard about or she heard about or somebody told him about using zinc. And he took high dose zinc and his schizophrenia went away. Have you ever seen anything like that?

Dr. James Greenblatt: Fortunate had one foot in psychiatry have always been in in patients. So I've seen the sickest, you know, most mental illness. And and we've seen psychosis reverse. Gluten is actually really common argument for Yeah. Psychosis Yeah.

Dr. James Greenblatt: Vitamin B3 and and, high copper as well. There are a number of variables that if we just tested and looked for Yeah. We could reverse

Dr. Mark Hyman: major.

Dr. James Greenblatt: I think

Dr. Mark Hyman: that's important. I mean, I've had a bunch of schizophrenic patients probably not have much issue, but I I, I was like, listen, I don't know if I can help you, but let's look and see what we can correct, and let's see how you do. And it's amazing to see how people improve. I mean, I and the data I literature, I looked at The literature about this. I was curious, but about 17% of people with schizophrenia have celiac disease.

Dr. James Greenblatt: Absolutely.

Dr. Mark Hyman: And it's undiagnosed. So in other words, you get rid of the gluten and they kinda wake up from their psychosis.

Dr. James Greenblatt: Yeah. No. I've read a a chapter in in, Hoffra's book just on gluten and psychosis. Besides the celiac diseases, other mechanisms, the non celiac. Yeah.

Dr. James Greenblatt: And now with all the kind of fuzz on metabolic psychiatry and the ketogenic diets.

Dr. Mark Hyman: Mhmm.

Dr. James Greenblatt: Now we have other tools Yeah. To treat psychosis. So there's information available. It's just not

Dr. Mark Hyman: being applied. Part

Dr. James Greenblatt: of, regular practice.

Dr. Mark Hyman: I'm sure, you know, Christopher Palmer's work, he's been on the podcast and talked about his work with psychosis and how he accidentally cured a schizophrenic patient by putting him in a ketogenic diet for weight loss and his psychosis went Right? And he wrote a book about it called Brain Energy, and he's he's been out there, which is fantastic. And it was funny because I I he I had him in the podcast. I said, you know, this sounds like when I wrote my book, like, 15 years ago, He's like and I I said, you might wanna check it out. He he he emailed you back a few weeks later.

Dr. Mark Hyman: He's like, listen. I'm so sorry. I promise I didn't plagiarize anything. I'm like, no. It's okay.

Dr. Mark Hyman: This is just how the body works. You know, everybody's gonna figure it out eventually. Like, it's not rocket science, but it's definitely not medical practice.

Dr. James Greenblatt: And the good news is that the information that that you and I've been talking about for 30 plus years is now seeping into academic medicine Yeah. To their metabolic clinics at Stanford. Yeah. Recycosis. McClain is starting 1 now.

Dr. James Greenblatt: So Yeah. It's it's getting there. This is a business.

Dr. Mark Hyman: This is amazing. But, again, I would I would kinda worry that that they're gonna get short sighted again because they go, oh, it's just a ketogenic diet. And that's the solution No. It's not. It's all these other things because you can do a ketogenic diet and if they have high levels of heavy metals or their guts a mess or they're having massive nutritional deficiencies,

Dr. James Greenblatt: That's been, you know, my pet peeve from, you know, psilocybin to ketogenic diets. These are tools they help. If you're not looking at the big picture Yeah. You're gonna miss something.

Dr. Mark Hyman: Yeah. I think that's important. And I think, you know, the the the whole fury now as a sort of start off with this concept of the mat Madison civilization and the different epics in history where we had a different view of mental illness. And now it's shifting to another view. I think this is closer to reality.

Dr. Mark Hyman: You know, I think it's a much closer view of actually what's happening because historically, our tools have been just really bad for mental health. Right? We have therapy. We have some drugs who which work on little, but not that great. You know, yep, beer's schizophrenic.

Dr. Mark Hyman: It'll help put you in a zombie state, but, you know, the chemical straight jacket, we call it but it's not really solving the problem.

Dr. James Greenblatt: The problem, you know, over the years for me in teaching this material, it it's not simple. You know, I make jokes, you know, I I should have been a hand surgeon, you know, to to learn 6 inches of of the body Yeah. Versus We don't know much about the brain.

Dr. Mark Hyman: The complexity of the human body is infinite, and it's impossible for anyone person physician to understand even if you're Einstein or, you know, the smartest doctor in the planet who's 150 5 Nobel Prizes, you're still never gonna be able to figure out the infinite complexity of the human body. There's 37,000,000,000,000,000,000,000 chemical reactions every second. You've got a 100,000 petabytes of data in your microbiome. You've got 1000 and 1000 of metabolites. You've got tens of thousands of peptides.

Dr. Mark Hyman: I mean, there's just so much going on all the time. That it's almost impossible to really understand it. But I would say using principles, theories, laws of nature, which I think is what functional medicine attempts to do is really describe the laws of nature when it comes to human biology. We can start to do things that work even if we don't completely understand them. Right?

Dr. Mark Hyman: We can help people improve their microbiome by changing their diet by giving them prebiotics, probiotics. We can get rid of bad stuff. They become antibiotics. For Cboe or any fungal treatments, and it improves her overall brain health and mental health and well-being. We may not actually understand everything about it, but we can still do it and it still works, which is kind of exciting.

Dr. Mark Hyman: So you don't like we have to, oh my god, I have to understand everything, and then we could start to apply this. We could apply it right now and and end suffering for so many people. What I'm really seeing now And this is worrisome to me. It's just this explosion of of psychiatric issues and illnesses of attention issues of autism, of violence, aggression, behavior, suicide, a whole spectrum. And it it just seems like it's more and more and more than it was 50 years ago.

Dr. Mark Hyman: And and I wonder if you have any insight because you've you've been in this for about that long. You know, what what's changed? And is this is this really true that it's all increasing? Because is it better detection, or or is it actually that more people are messed up?

Dr. James Greenblatt: I think it's clearly increasing. The the good news is people now talking about it, but I I think absolutely rates of childhood may are mental illness from eating disorders to ADHD, it's increasing. And I think the factors are broad. I mean, our our diets are the, you know, ultra processed foods, that, are now catching up with us for the last 30 years has profound implications for child mental health. Hey.

Dr. James Greenblatt: Social media You know, I don't see it as a cause. I use the term, the gasoline on the fire. Yep. So I don't I don't think it's causing it, but it's kind of you know, the gasoline on the fire. And then, you know, all the environmental things that bind nutrients, a lot of my interest has been with, the trace mineral lithium.

Dr. James Greenblatt: 1000 of hair tests of kids with lithium. When I started, you know, I'd get, like, 25, 30% undetectable lithium in the hair. Now I'm seeing 75%. Wow. So I don't know if if it's the bottled water.

Dr. James Greenblatt: We're not getting lithium from our natural tap water sources. Or other environmental things binding it, but I I believe that's a factor. So between the environmental toxins between the malnutrition, the sugar, the kinda I believe the genetic vulnerability catching up with us It's just a kinda perfect storm that has resulted in kind of this mental health crisis. Although, you know, I I always stress that I I'm tired of hearing the term mental health crisis because I I think the better term is for us, it's a crisis of care. It's the model.

Dr. James Greenblatt: Yeah. Because it is treatable. It's not just numbers going up.

Dr. Mark Hyman: Yeah. I I think this is so important and it's hard for people to understand the power of this approach. Oh, okay. Take a little vitamin here, change your diet there, maybe to do this for that and it'll help. But we're talking about radical shifts in people's biology that affects their Depression.

Dr. Mark Hyman: I mean, I I remember one patient I had who had really severe depression. She also had really severe weight issues and gut issues and a million other things going on. And introduction really helps a mercury. And we treated her, and her all her symptoms went away. Her depression went away.

Dr. Mark Hyman: Now most psychiatrists are not checking for mercury. They're not checking your poop test. They're not checking your vitamin levels. You're not looking at, you know, your hormones probably. Maybe they'll look a little bit of thyroid if you're always low.

Dr. Mark Hyman: They'll give you a T3, but then it's it's kind of not even on the radar. I'm just so blown away by the degree of improvement in space patients. And I'm sure you've seen the same thing. I wonder if you maybe share a few stories of some of your cases over the last years and what what what you found me so kind of mind blowing.

Dr. James Greenblatt: These are particularly children who were put on a trajectory of of major mental illness, you know, inpatient hospitalizations, multiple medications. And once you're on that path, it's it's hard to get off that chain. Yep. You know, I have a bunch of cases with just celiac disease. So chronic malnutrition from age six to age twelve is gonna, for some individuals, result in major mental illness

Dr. Mark Hyman: Wow.

Dr. James Greenblatt: Anxiety, depression. And just treating the celiac disease, those symptoms get better. So my favorite stories are kind of these irritable, aggressive kids kicked out of private schools. Yep. You know, the schools that are getting a lot of money from a parent and, low dose nutritional lithium kinda was the answer.

Dr. James Greenblatt: They have a family history of major mental illness. They're aggressive. They're irritable. And just small amounts of nutritional lithium was enough to kinda keep them, behaving.

Dr. Mark Hyman: So I deal with, like, behavior issues ADHD and

Dr. James Greenblatt: These were kinda more severe, but they were ADHD, but the impulse control was such where they would hit other kids.

Dr. Mark Hyman: Oh, violent. Yeah. Kids. Yeah. Oh, the mini sociopaths.

Dr. James Greenblatt: Well, no. They they're they felt bad. The sociopaths wouldn't feel bad. These kids would hit, and then they'd feel terrible. They just couldn't control their impulses.

Dr. James Greenblatt: But these tiny amounts of nutritional lithium, they were able to kind of inhibit that aggressive impulse. And, and be able to actually get back in school.

Dr. Mark Hyman: I've reminds me of a a case I had who had severe behavior problems. He was twelve years old and been, you know, ticked out a kindergarten for, you know, being disruptive and was on ritalin for years and, you know, diet fully junk food, processed food, just struggling, you know, very, very sick. And also had other issues. He had, like, gut issues and irritable bowel and allergies and headaches and insomnia and anxiety. And, look, so he had a whole pro list of problems, right, anal itching.

Dr. Mark Hyman: And I think that most psychiatrists wouldn't pay attention to or care about but there were all bits of data that were highly important. So things that most psychiatrists would discard is, oh, that's not my domain Mark actually the answer. Right? And they're not looking in the right place. And and this kid was just such a striking case because we we basically put him on elimination diet, got him on a Whole Foods, replenished to the nutrients he was missing.

Dr. Mark Hyman: He was missing everything. Zinc, magnesium, omega threes. He had high trans fats. He had low b 6. I mean, just the whole Bucket, basically, was empty.

Dr. Mark Hyman: We got rid of a little lead that was in his system, and we fixed his gut. He had a lot of grow overgrowth of yeast because of all the sugar and everything aid, and we kinda cleaned up his gut And 2 months later, the mother comes back. And she's like, well, my little kid's better. And I'm like, really? She said, yeah.

Dr. Mark Hyman: Here's his homework. From before and after. Here's his handwriting before and after. And and we're gonna put in the show notes. I wrote an article about this in in a medical journal, and I I published it because it was just so compelling.

Dr. Mark Hyman: And in the you couldn't read his handwriting. He had severe what we call this graph here, which is really bad handwriting. I got mine after medical school, so I don't think I you know what? It was an early onset condition. But but his handwriting in 2 months went from illegible to perfect penmanship.

Dr. Mark Hyman: There was no you know, occupational therapy or handwriting lessons or any of that. It's just his brain went from being completely asynchronous chaotic and dysfunctional, dysfunctional, and coherent. And he was able to actually not only had better handwriting, but not have ADD anymore. Not have behavior issues, not have any of his other health issues, like his gut issues and his headaches and his skin issues, and his allergies all went away. And I was like, wow, this is amazing stuff.

Dr. Mark Hyman: And that's kinda what got me to write this book, the accent of this this Ultramized solution. And and, talked to this kid, you know, years later, and he graduated from, like, aerospace Engineering or something, you know, so and we we we really have a whole generation kids that are that are being neglected in my view, they're being maltreated because they're not actually taking advantage of the current evidence of science is what we're talking about. It's not stuff we made up, you know, in our garage. It's stuff that's in the literature. Right?

Dr. Mark Hyman: It's just not being applied. Right. So maybe take us through the lithium story because I think most people might have heard about this. Lithium sounds like it's something you treat bipolar patients with. It's something that's we learn in medical was toxic.

Dr. Mark Hyman: You have to measure blood levels. And you don't wanna take too much of it, and you can get thyroid suppression. And it's like a little bit of a hairy thing when you use it as a doctor. So Can you kind of take us through the the difference between therapeutic, medication pharmacologic doses and nutritional Sure. Working therapy what we mentioned some of the causes filtering water that's in our soil.

Dr. Mark Hyman: It's in our in our water, but we're we're not, you know, getting those now. And if you're seeing this increase in in sort of nutritional lithium deficiency. And we don't think of it as a vitamin or mineral. We need calcium. We need magnesium.

Dr. Mark Hyman: We need zinc, but nobody said, oh, you need lithium. Right?

Dr. James Greenblatt: So in my world and, my world work is I'm quite convinced there's such a thing as a lithium deficiency disorder. So lithium, the story, it goes back, you know, 13.8000000000 years, the big bank, No. So there are only 3 elements, hydrogen, helium, and lithium. Really? And the big bang.

Dr. James Greenblatt: So lithium goes way back and the earth's crust is filled with lithium. So lithium is a natural element, and it's essential for human health in small amounts. And the early studies in in lithium In the seventies, demonstrated the amount of lithium in our in the tap water, in our drinking water varied geographically. If you first studies were in Texas, one part of Texas, high lithium, guess what? They had low rates of suicide and mental illness.

Dr. James Greenblatt: Another part of Texas had low lithium. They had high rates.

Dr. Mark Hyman: Interesting.

Dr. James Greenblatt: And we've done these studies all around the globe. And the amount of lithium in the tap water predicts exactly rates of suicide. High lithium low rates.

Dr. Mark Hyman: Mhmm.

Dr. James Greenblatt: And and we can 15 different countries, millions of of data points.

Dr. Mark Hyman: So it's a pretty strong correlation. It's not causation, but it's a pretty relation. Right?

Dr. James Greenblatt: And so it's an essential mineral and, convinced that genetics, some people need more. And also nobody's drinking tap water anymore. We don't get a lot from our food. Most of it was from the water. So there's small amount of lithium to micrograms, milligrams a day might be what we need as some people estimate.

Dr. James Greenblatt: Many people aren't getting it.

Dr. Mark Hyman: Yeah. There was a day when tap water was safe to drink. None Mark. We never had bottled water. I was like, yeah.

Dr. Mark Hyman: You just drank the tap water.

Dr. James Greenblatt: And those individuals with family histories of addiction, aggression, bipolar, I believe those families have just a higher need for lithium. And if they're in the wrong you know, geographic area, they're gonna have symptoms. So small amounts of what we call nutritional lithium. 1, 2 milligrams. Can have major implications for mental health.

Dr. Mark Hyman: 1 or 2 milligrams.

Dr. James Greenblatt: I started 1 or 2, maybe go up to 10 or 20 milligrams.

Dr. Mark Hyman: In medicine when we use it for bipolar disease is like 300 or 600 milligram.

Dr. James Greenblatt: Or 1800.

Dr. Mark Hyman: Right.

Dr. James Greenblatt: Yeah. Yeah. So 6 to 1800 It is it is toxic, does have side effects, ex thyroid, and kidney. So as psychiatrists we shy away from, prescription lithium. But as functional docs, we should be thinking about low dose nutritional lithium.

Dr. Mark Hyman: And how do you measure it? Because it's not on blood tests that you can do. Or you got to do a hair analysis.

Dr. James Greenblatt: Hair analysis is I find the most helpful because there should be no blood level of lithium for any of us. So blood tests aren't gonna help So a hair test, we all should have a little lithium in our hair, and you'll see many individuals have undetectable lithium.

Dr. Mark Hyman: So, normally, when you have something in your diet, mineral. It gets excreted in the hair, whether it's heavy metals like mercury or minerals. So a hair test can check for minerals. It can check for metals. So it's a very useful we don't use it much in medicine a little bit.

Dr. Mark Hyman: 30 years ago, I

Dr. James Greenblatt: was, I, you know, wouldn't get up in front of my colleagues and talk about a hair test. But now it's so essential So my practice as a child psychiatrist, I'm very comfortable talking about working both at heavy metals, lithium, magnesium, copper, zinc.

Dr. Mark Hyman: Yeah. I mean, it was, there was a JAMA article published years ago about, president Andrew Jackson, and the article was basically talking about how crazy he was. And and how they found a bunch of his hair and they analyze his hair. And it is hair. They found high levels of mercury and lead, which may you crazy.

Dr. Mark Hyman: Sure. And the Mercury came from a remedy that was used for almost everything back in the 1800. It's called Calamel. Hash was a a memory for infection and for pretty much everything. So Lewis and Clark took across the country.

Dr. Mark Hyman: And also he was a bit of a hot head, and he would get all these duels and get all these lead buckshot in him. So the lead from the the gunshots and the Mercury made him nuts. So that was Andrew Jackson. But that was a hair test that they published in JAMA. So it's not that that medicine doesn't understand that these things are in here.

Dr. Mark Hyman: What is a sort of level of evidence around lithium use and and the issues around mental health. Are there any clinical trials? Is it all is it all sort of population based data? Like, what do what do what do you know about the date on this?

Dr. James Greenblatt: You know, we have, a lot of literature on the psychiatric doses, you know, being helpful for dementia, as well as aggression irritability. Mhmm. And we have a lot of epidemiological data extensive on these trace amounts in the water supply. So we know, again, suicide risk, dementia risk, aggression based on how much is in the water. There has not been a lot of studies on low dose nutritional supplementation.

Dr. James Greenblatt: There's a few based on, research looking at dementia and Alzheimer's. So low dose preventing cognitive decline, and a few looking at, addiction treatment.

Dr. Mark Hyman: You know, medicine, we have kind of a snotty view of anecdotes. We call them anecdotes. But, No. They're also, addict data. And they're also, what we call edit 1 studies where if you have a person and you do something and they're their own control.

Dr. Mark Hyman: And now of course, Placebo plays a role in a lot of other factors. But, you know, tell us some of the stories about cases you found significant deficiencies. Like you mentioned, ADD, what what has been the clinical outcomes from using these low doses of 1, 5 milligrams.

Dr. James Greenblatt: You know, I think the term that, cuts across all major psychiatric illnesses and and many of us would be the concept irritability. So to me, that is the symptom that lithium helps. So I've seen, you know, a woman came to see me for depression, she couldn't get off for anti depressant. She was an alcoholic family history of alcoholism. While we were waiting for the testing, because of her family history, I just gave her 5 milligrams of lithium.

Dr. James Greenblatt: When she comes back in the office to go over the testing, she just started crying

Dr. Mark Hyman: Really?

Dr. James Greenblatt: Why? Because she, one, felt so good. The 5 milligrams of lithium, she said she didn't realize how angry and nasty she was who for adolescent daughter and her husband.

Dr. Mark Hyman: Wow.

Dr. James Greenblatt: But just said 5 milligrams of lithium completely took that away. And again, wouldn't be for everybody. But we have found actually, I learned this from Jonathan Wright 40 years ago, those with family histories of addiction, particularly responsive to this slow dose lithium.

Dr. Mark Hyman: Really? It's such a benign treatment, and it's so inexpensive, like, literally pennies a day. Right? Right.

Dr. James Greenblatt: No blood level, no side effects.

Dr. Mark Hyman: How does it work? Do you know how it works?

Dr. James Greenblatt: It's fascinating. Actually, there are hundreds of mechanisms, you know, both affecting genes, second messengers, affecting neurotransmitters. I mean, really, the list of 2030 mechanisms that we've identified over the years And which mechanism, you know, is the answer? It's hard to tell. I mean, lithium increases BDNF, brain derived neurotrophic factor.

Dr. James Greenblatt: Both the app, the genetic synthesis, as well as some rates in the in the serum. And so we have literature supporting it.

Dr. Mark Hyman: That's amazing. And and you also talk about lithium as a treatment in the Alzheimer's area.

Dr. James Greenblatt: The prevention. Yeah. And again, we've known prescription lithium Those with bipolar taking it less dementia rates to start looking at low dose lithium. We have 1, 2, there's some 4 year studies It prevents cognitive decline.

Dr. Mark Hyman: Wow.

Dr. James Greenblatt: There are biotech companies looking at drugs that are called GSK3 inhibitors. Right? And lithium is a GSK3 inhibitor. So it kinda prevents some of the buildup of these tau proteins and things.

Dr. Mark Hyman: Well, it seems like a Herinologist, which is pretty inexpensive and easy to do and non invasive should be part of every psychiatric practice.

Dr. James Greenblatt: I would think so. It's certainly my recommendation.

Dr. Mark Hyman: I mean,

Dr. James Greenblatt: that we have so many tests as functional medicine doctors, but I do think there are core set of 4 or 5 tests that should be done on every psychiatric patient to be able to kinda start

Dr. Mark Hyman: that process. What are yours?

Dr. James Greenblatt: Mine for for psych patients would be cryptopiro. Ah, amino acid, fatty acid, organic acid, and, hair test. Besides the routine you know, Labcorp, West B Twelve and D, and all that stuff.

Dr. Mark Hyman: Yeah. And we may get 3 fats and Yeah. Celiac, gluten. Absolutely. That's up there.

Dr. Mark Hyman: So you just mentioned a bunch of stuff that, probably most people never heard about. I mean, the acid testing, organic acid testing, peripheral testing, these are things that are pretty common in the functional medicine world, but that are not part of standard medical practice. If you go to your doctor after you listen to this podcast and ask for I always have a cryptopiral test or, again, a guest test to look at you like your, you know, from another planet. How how a psychiatrist or someone in mental health field can start to learn about

Dr. James Greenblatt: It's challenging. And and that's why we started psychiatry redefined. So it's really set up for professionals to it's kind of a 2 year training program because it it does take time to help them understand some of these tests and to interpret them and then how to treat patients. Because, you know, our sick patients are sometimes challenging for lots of reasons. So we can't just throw 20 supplements So there is a an art and a science to it.

Dr. James Greenblatt: So, you know, many of the lab companies offer trainings, but it's not focused on mental health. So, you know, wasn't on my plan to be teaching this, years ago, but there just wasn't enough out there.

Dr. Mark Hyman: Nutritional Functional medicine psychiatry is something that's it's such a gap in the in the field of medicine, and there are just a few people doing it now. I I'm just stunned at how effective it is. You know, it's one of those things in in medicine. They're like, wow. This is just short of a miracle.

Dr. Mark Hyman: I hate to be hyperbolic about it, but, you know, I when you if you kind of check out Doctor Greenberg's book, and read my book Culture Mind solution, you'll just see this case after case of miracle stories. I mean, like, it's the kind of girl who was this violin little girl, she was nine years old, super aggressive, kicked out of class ten times a day, couldn't make it home on the bus without the bus having to stop, like, ten times, you know, basically was suspended from school. And she was this beautiful little nine year old girl, and she was beating up on her sister and tearing pictures of her family apart. Just like kind of a terror. And she didn't have any gut symptoms, but I I did check her organic acids.

Dr. Mark Hyman: And I I found, this is a urine test, non invasive, easy view on kids, and she had extremely high levels of bacterial overgrowth and de silver growth, with And and by the way, if you're listening, you know, it's kinda shocking to think about it, but but there's a lot of things that happen in your gut, and those things get translated across your intestinal membrane and get absorbed in the blood and then come out of the urine or you can check them in the blood. So we're gonna be stew be able to to soon look at your microbiome by doing a blood test. Right? So that's crazy to think about, but I was talking to Leroy Hood who's the father of assistance biology yesterday. And he was going through this.

Dr. Mark Hyman: I was like, this is amazing. So so this little girl had really high levels. So what did I do for her? I didn't give her you know, psychiatric drug to calm her down or some antipsychotic or some, you know, thing that kind of suppress her symptoms I just gave her an antibiotic and an antifungal, and I gave her a little gut repair. And the mother came back, you know, a few weeks later, and she's like, She's perfect.

Dr. Mark Hyman: I'm like, really? You gotta be kidding me. Like, that couldn't have worked, but it did. And and And and it doesn't mean that every kid like that has that problem. Like, we said at the beginning, just because you know the name of the diagnosis doesn't mean you know what's wrong with you.

Dr. Mark Hyman: You gotta dig and you gotta find out it's different for everybody. So you just mentioned a word that probably no one's ever heard about, crypto pyrolleria, which It's a big gobbledygook mouthful of scientific term that is basically something that has been linked to psychiatric disorders behavior issues, aggression, autism, ADD. It's something we don't learn about in medical school. It's something I learned about afterwards. And it's it's something that we can actually test and treat.

Dr. Mark Hyman: So what is this compound? What is cryptopyluria? Why does it occur? And What is a cause and how do we begin to think about treating it and testing for it?

Dr. James Greenblatt: As you said, it is a simple urine test that I believe has profound implications for mental health. Right. The problem for me, it's one of the few things that I teach now. I don't have a lot of research. But I have thousands of clinicians and my 30 years with clinical experience that if we can detect this chemical in the urine, we know that these individuals are gonna be functionally deficient in 2 nutrients, B6 and zinc.

Dr. James Greenblatt: So this some kind of pyromolecule Most people don't have high amount. If you do, it binds B6 and zinc, and both are critical For mental health, b 6 for neurotransmiticin, this is zinc for 100 of enzymes. So over time, the depletion of b 6 and zinc We see symptoms from anxiety. I've seen depression. I've seen paranoia.

Dr. James Greenblatt: I've seen actually every psychiatric symptom. It doesn't always is the answer, but until we treat it, we can't treat anything else.

Dr. Mark Hyman: Yes. So

Dr. James Greenblatt: again, it's an inexpensive test. Implications are profound. We give b 6 and zinc and some of these kids have tremendous,

Dr. Mark Hyman: reverse on symptoms.

Dr. James Greenblatt: The zinc is pretty normal. 30, 60 milligrams. The b 6, we can actually push up. So much higher than I might normally. So it could be 50, a100.

Dr. James Greenblatt: I've been up to 400 milligrams. I can. It's such a simple test. We just make sure it goes down. And under stress, we can see individuals will produce more

Dr. Mark Hyman: Yeah.

Dr. James Greenblatt: Cryptopyrrol so they can kinda modulate stress by taking more b 6 and saying

Dr. Mark Hyman: So what caused it? Is it a genetic thing? Is it, acquired somehow by what you're doing or eating? Or

Dr. James Greenblatt: We don't know. I mean, the the kind of word you know, in the communities, it's likely genetic. Yeah. In terms of how we produce it and, the and then under stress, it just gets higher. But it is a screening test on every individual I see.

Dr. Mark Hyman: Is the treatment? I mean, does it does it really work when you give me What's traumatic?

Dr. James Greenblatt: B 6 and zinc. Now it might be might have an ADHD kit. It might have elevated crypto pyro, high copper, and low magnesium. So you can't just do the b 6 and zinc. You're gonna give all these You can't do one thing.

Dr. James Greenblatt: You gotta do everything. Yeah.

Dr. Mark Hyman: Right? You gotta kinda it's not the kitchen sink, but it's it's a very selected group of interventions based on that particular person's findings. And this is really precision psychiatry. It's really where we're all headed.

Dr. James Greenblatt: Absolutely.

Dr. Mark Hyman: And precision medicine in general. It's not one size fits all. Okay. You're depressed. Take Prozac.

Dr. Mark Hyman: You know? But depression is not a Prozac deficiency. Is not a real inefficiency. Right?

Dr. James Greenblatt: And, you know, we're moving on pretty quickly in oncology and other medical specialties. See. You know, psychiatry and mental illness is just really lagged behind that concept of precision medicine.

Dr. Mark Hyman: Yeah. And it it's exciting to me to see that's actually starting to happen. Like you mentioned, in in major academic institutions, their departments of nutrition psychiatry, metabolic psychiatry, looking at the microbiome and mental health. I mean, it's quite it's quite amazing to see the changes happening since the last few years. So I'm pretty excited about it.

Dr. Mark Hyman: Think it's not fast enough for the amount of people that are suffering, but it's it's pretty cool. You know, one of the things you work on that I think is really important and it is, tough condition to treat, which is eating disorders. You know, most people have a view, and this just goes back to the original sort of conversation about Michelle Faco and Madison civilization, that that eating disorders are a result of, you know, controlling parents and it's the parents fault and the kids just trying to control the thing that they can control and which is why they starve themselves or they have bulimia and And it's not quite as simple as that. Right? So can you cut out and pack what we know from a functional medicine perspective about anorexia.

Dr. Mark Hyman: And I and I had a number of these patients early on. It taught me a lot about about this condition, but what do we know about how to think differently about taking care of these patients in a way that actually helps them. Sure.

Dr. James Greenblatt: I think, one thing I didn't know when I got in the field of eating disorders is it is the most, life threatening psychiatric illness. So eating disorder patients have the highest risk of suicide. Highest mortality rate the same as overdoses. So it's it's a life threatening illness. And our traditional model, we have no medications and with no consistent therapy.

Dr. Mark Hyman: Remember Karen Carpenter? She was like, probably most of you don't know what that is. She was like, it was a band way back in the seventies. Absolutely. Sure.

Dr. Mark Hyman: She had an erection. She died from it.

Dr. James Greenblatt: Yes. And so our model for years was just some feeding calories, and they would gain weight and then go home and relax.

Dr. Mark Hyman: And they'd give him junk food?

Dr. James Greenblatt: At anything to gain weight calories. And so what we're now understanding that I'm still hitting, you know, my head, trying to get people to appreciate is it's pretty clear these individuals are malnourished. I believe, anorexia nervosa in particular is a zinc deficiency disorder. It's the clash of puberty. We have a high need for zinc.

Dr. James Greenblatt: And, sometimes a a a diet deficient in zinc.

Dr. Mark Hyman: 60 7 percent of kids diet is ultra processed food, which essentially has no zinc or anything else except sugar and processing ingredients.

Dr. James Greenblatt: And then we go through puberty. We have a higher need for zinc. And guess what? Genetically vulnerable individuals. So what we do know about eating disorder is highly genetic.

Dr. James Greenblatt: And then one of the causes is, malnutrition. And then this disorder goes. Now there's clearly other factors, you know, it's like the social and social media and parents and pediatricians calling these kids fat or they need to lose weight. There are multiple factors. Yeah.

Dr. James Greenblatt: But what happens is a change in diet restrictive eating malnutrition.

Dr. Mark Hyman: But but it's a chicken of the egg. Right? If they if they don't eat, obviously, they're gonna be malnourished, but is that what caused them to not eat in their first place?

Dr. James Greenblatt: No. So anything might cause them to not eat. I need to lose £2 or I wanna lose weight for this sport. So Any form of dietary restriction starts that process. But again, 10 kids who go on a diet Only one might develop what we call anorexia nervosa, this unrelenting kind of fear of food.

Dr. James Greenblatt: And so, again, it's a genetically vulnerable individual malnutrition, psychological factors, perfect storm. And it's a life threatening illness.

Dr. Mark Hyman: Yeah. And it's really resistant to treatment. So So how do you treat this? And you what's the success rate you're seeing in these patients?

Dr. James Greenblatt: Well, the standard of care is somewhere, you know, 56 to percent. I think the programs that that I work in it walled in and other programs where we have been able to kind of diversify and and look at micronutrients I think the success is my hire and patients that see an outpatient who can really follow a micronutrient, repletion plan completely can recover.

Dr. Mark Hyman: That's incredible. I mean, that's a really hopeful story because it's a it's, and you said it's one of the most serious psychiatric conditions, and it's you know, the whole kind of culture of fat being afraid of being overweight and and body Just Morpheus, it's a real thing, and it's it's amplified by our culture, but but the underlying kind of place where that liaison top of is a place of of all sorts of other factors that are predisposing people like nutritional deficiencies.

Dr. James Greenblatt: Yeah. There's an underlying genetics clearly biology Yeah. Brains different. Everything's different. Part of my goal is just stopping the the blame game of parents, blaming kids, and kids, blaming parents.

Dr. James Greenblatt: They can appreciate it as a serious medical illness. There's a path to treatment.

Dr. Mark Hyman: One category meant illness, I don't really it's been talked about much his personality disorder. Narcissism sociopathic behavior. I I talked about this before in the podcast, but, you know, I read a study, couple of studies about juvenile detention centers and prisons where they swap out the bad food for good food, and there's, like, 97% drop in violence inside juvenile detention centers or 56% drop in prisons and 80% of you add a vitamin. Yes. So what what about personality disorder?

Dr. Mark Hyman: Because it's kind of a black box in medicine. There's really no good treatments. There's really no good approaches to it. There's no drugs for it. What have you found in your career as as a as a psychiatrists who practice this way that may be helpful for some of these personality disorder patients.

Dr. Mark Hyman: Because I I just to kinda back up a little bit, the way we define precisors in medicine is, you know, uh-uh, a neurotic person or neurosis is someone who thinks everybody else is fine. They drive this house crazy. And that precise order thinks they're fine. It drives everybody else crazy. Right.

Dr. Mark Hyman: Right? So it's kind of definition.

Dr. James Greenblatt: So if we just separate some of the personality disorders, if we take one that's, common, talked about borderline personality, These are individuals who are impulsive, emotional, irritable, angry, labile. So we call it a personality disorder. We could say it's just who you are. We can't treat it. But those are all responsive to nutrient intervention.

Dr. James Greenblatt: Particularly the low dose lithium I talked about, the omega threes I talked about

Dr. Mark Hyman: Yep.

Dr. James Greenblatt: And magnesium that you brought up.

Dr. Mark Hyman: Yeah.

Dr. James Greenblatt: So I've seen these personality disorders some of the disabling symptoms disappear?

Dr. Mark Hyman: Mhmm. Yeah. So in a in a way, you know, bird borderline is is sort of borderline psychosis. So it's a little bit more extreme kind of what about narcissism? Is that is that also related?

Dr. James Greenblatt: Not probably the personality disorder, but maybe some of the symptoms. What if we, again, just took that irritability and and quick to anger? So, yes, that might be responsive to magnesium and nutritional lithium. Right. But some of the other kind of personality structure is probably who you are.

Dr. Mark Hyman: Well, I I'm just so, inspired by this conversation because I think that most people, have a view, fatalistic view of mental health issues. You know, If you're a depression, it's kind of a terminal illness. If you have anxiety, you just have anxiety. If you have a, schizophrenia, well, good luck. You know, if you autism or ADD, and you gotta live with it.

Dr. Mark Hyman: And what you're proposing is a whole new rethinking of psychiatry and re imagining of mental health that redefines it based on our current understanding of how the brain and the body are connected and how everything from nutrition to exercise to our gut health, to toxins, to our genetics, to anything that drives inflammation, because basically most psychiatric issues are really about neuroinflammation. In the brain, whether it's autism or Alzheimer or depression, we're learning that they're all basically inflammatory disease of the brain. And suicide risk.

Dr. James Greenblatt: I mean, we know inflammatory markers in the brain predict suicide.

Dr. Mark Hyman: We have to research ignored. That's incredible. I mean, and and, you know, suicide is a 3rd leading cause of death in teenage boys. So this is a big deal. And what causes inflammation mostly our processed food diet, environmental toxins and our screwed up gut microbiome from eating that way.

Dr. Mark Hyman: And it's like a it's like a simple fix, really, if you look at actually what what's going on, and yet we don't really approach it that way. So your whole your whole re imagining of psychiatry, you call it psychiatry redefined. I think it's just an incredible gift to the world. I think your work is so important. And I I sort of wanna sort of close by talking about What you call the the plus minus healing plan, in in psychiatry.

Dr. Mark Hyman: Cause I think it's a it's a in a useful a stick or kind of rule of thumb to use to think about how we start to approach people with pretty much any disease, but let's we're talking here about mental Yeah.

Dr. James Greenblatt: No. I mean, that's how we kinda wrote the the finely focus, the ADHD book. You know, how to how to explain functional medicine to a parent. Yeah. And, so we just came up with this plus minus plan plus meaning what things do you need to add?

Dr. James Greenblatt: And that could be everything from nurturing to magnesium to other phytochemicals And then what things do you need to minus? And that could be food additives, ultra processed foods, high copper. And so we just listed 10 things plus minus help them kinda with a guide of of how to test and then how to treat. But I I just think it was a simple framework to help parents really appreciate that there are things that might be contributing to their kid's symptoms.

Dr. Mark Hyman: Yeah. It's very, very similar to, my mentor who I'm sure also you've learned from as well, Sydney Baker.

Dr. James Greenblatt: Oh, absolutely.

Dr. Mark Hyman: Who is, you know, one of the I think one of the unsung heroes of modern medicine has really came up with a lot of the fundamental, I would say concepts or heuristics or frameworks to think about complex chronic illness. Yes. And, he he said, you know, you have to think about what you need to get rid of and what you need to get. Right? So you get rid of the bad stuff and you put in the good stuff, and the body knows what to So you don't actually have to understand it all.

Dr. Mark Hyman: You just kinda have to go hunting for what's the bad stuff and get rid of it and have to go hunting for what's the good stuff and add it. And and what's missing, right, that's missing. And and there's basically ingredients for health and impediments to health. And if you move the impediments, you add the ingredients, the body is pretty smart. And even if we don't know exactly how it all works, it works.

Dr. Mark Hyman: And people get better. And that's the end of the day what we care about is helping our patients and helping people and needless suffering. And that for me is really what drives me is is just the the the the and I I'm just I'm flooded every day. With request for help because of what we do, and I'm like, god, this is so easy to solve, and nobody's helping you. And I'm so sorry.

Dr. Mark Hyman: And y'all try. And, you know, they come to my practice, the ultra wellness center. It goes, you, and where you you practice in at at Walden, which is a psychiatric treatment center, people can get this help, but it's far between it. It just really needs to be developed at scale. So if you're out there listening and you're meant to help if you're a psychologist, a psychiatrist, a counselor in any space, this is something you should pay attention to and check out Doctor Remlot's work, go to psychiatry

Dr. Mark Hyman: You can take the courses. The reality is this, a lot of the stuff doesn't require any kind of sophisticated treatment other than, like, diet lifestyle and sometimes supplements that could be very helpful. So the basics actually are quite simple to implement. Like you say, take out the bad stuff, put in the good stuff, cross your fingers, see what happens. Now it's not gonna fix everybody.

Dr. Mark Hyman: Right? You're still gonna have to then go digger, and that's we need help from somebody like you or me who can really dive deeper into the story and figure out what the issues are and do deeper diagnostic testing. But I'm curious how you're received now, you know, in terms of your work around the psychiatric community. Are they are they welcoming now? Are they dismissive?

Dr. Mark Hyman: Are they curious? Are they like, I don't know. I'm busy. Give me It'll bother me.

Dr. James Greenblatt: Well, I mean, I've kept my, one foot in traditional psychiatry by treating, you know, anorexia for 25 years. Because I could talk about zinc and fatty acids because everyone was malnourished. But I would say the last 5 years, I've been doing more talks for traditional psychiatrists, big psychopharm conferences,

Dr. Mark Hyman: Unferred.

Dr. James Greenblatt: And hundreds of dogs. And it's been amazing to me. I've been talking about this, and they're asking questions about themselves and their families. Place.

Dr. Mark Hyman: Yeah. Of course.

Dr. James Greenblatt: They're they're not realizing that they could utilize this information to treat their patients.

Dr. Mark Hyman: Right.

Dr. James Greenblatt: But at least the traditional psych world now clearly is is ready for the information.

Dr. Mark Hyman: Yeah. So Yeah. It is. It seems like it's a very, suspicious time where things are actually starting to shift and change in the paradigm shifting and the convergence of cyst's biology and diagnostic testing and ability to actually track what's going on. Now I co founded a company called function health, which allows people to get access to their own data in their own lab testing.

Dr. Mark Hyman: So a lot of things you're talking about, we measure. Right? We measure metabolic health. We measure nutritional, things like B12 and methylic acid and vitamin d and magnesium and zinc, just standard, right, copper. We look at it, and we can also look at omega-three fats at lot of things that you're talking about, we we do.

Dr. Mark Hyman: And I think it allows people to start to have agency and ownership over their own health and become the CEO of their own health and be guided by simple insights, it could be helpful. So it's super exciting. I think, you know, people can, check out your book, functional medicine for antidepressant withdrawal. You have another one called finely focused the breakthrough natural treatment plan for ADHD that restores attention, minimizes hyperactivity and helps eliminate drug side effects. You got us psychiatry to find fellowship and ADHD intensive for practitioners could have just kind of sailed off into the, sunset and relax, playing golf somewhere, but you're working hard to make sure that all the amazing wisdom that you've accumulated through decades, literally almost half a century of practice and learning are are are accessible to the next generation of practitioners and they're gonna help millions of people.

Dr. Mark Hyman: So thanks so much for your work and what you've done. Any final thoughts

Dr. James Greenblatt: or No. I think we we hit a lot. And I think we've said it a couple times, but I think the most important thing in in functional medicine for psychiatry is everyone's different, and we really need to kinda provide the path for for hope as we look for what's going on with that individual.

Dr. Mark Hyman: Yeah. So I would say if you're out there listening, hope is is really the word I would leave you with, which is despite what you may think and what you've been told by the traditional psychiatric world, there are tremendous number of things that you can do and learn about and get help for that are outside the box that are really not outside the box that are in the scientific literature, but they're not in the practice. They're not in the clinic. You can learn more about it. I can check out my book Ultra Mind solution.

Dr. Mark Hyman: We're gonna put all this in the show notes. So thank you all for listening today to this conversation with Doctor James Grimblatt.

Dr. James Greenblatt: Thank you.

Dr. Mark Hyman: 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 Doctor Mark Hyman, 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 signing up for my free Mark picks newsletter at doctor forward slash Mark picks.

Dr. Mark Hyman: 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 things that have helped me on my health journey, and I hope they'll help you too. Again, that's doctor Hyman Mark. Thank you again, and we'll see you next time on the doctor's forms. This podcast is separate from my clinical practice at the Delta Wall Center and my work at Cleveland Clinic And Function Health.

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