Why Processed Foods Are Worsening Your ADD and ADHD Symptoms
01:19:12 Share

Coming up on this episode of The Doctor's Pharmacy. And you can bring 10 kids in here with ADHD, right, or the label of ADHD, and each one of them is going to be treated differently because they're all going to be different. Their genetics are going to be different. Their environments are going to be different. Their supports are going to be different.

I was recently asked, what's an important supplement you wish more people knew about? Well, astaxanthin. Research on this marine super nutrient is exploding with more than 3,000 scientific papers and 100 human studies. It turns out this potent antioxidant perfectly spans cellular membranes, protecting them from damaging free radicals both inside and out. Astaxanthin also fights inflammation.

It promotes mitochondrial function, induces autophagy or cell cleanup, and reduces cellular senescence or aging. All good things. This results in whole body health and longevity benefits. In fact, it was proven to extend lifespan in the world-renowned NIH-funded interventions testing program, essentially a program that looks at all molecules to see what works for longevity, and it's one of the few proven to expand lifespan. So what brand do I take? I trust AX3, BioPure Astaxanthin, because it's

the version that was tested in the NIH longevity study, and it has superior purity and bioavailability. It was actually shown to be absorbed three times more effectively than ordinary astaxanthin. And I personally met with the AX3 team and was impressed by their deep knowledge and decades of experience working with astaxanthin.

My friends at AX3 are honored to share Astaxanthin with you and are offering 20% off your first order at ax.life slash hymen with the code hymen at checkout. ax3.life slash hyman. For me, being healthy means being able to get up every morning and do exactly what I want to do, no matter my age.

age. In fact, I recently hiked 15 miles in the snow in the mountains of Patagonia. I was sore and tired after, but so was my 28-year-old guide who was half my age. And that's why I'm excited to share a supplement that's been a game changer in my fitness journey, Timelines MitoPure. As you age your mitochondria, the tiny energy factories inside the cells of your muscles and organs become less efficient.

And this can cause your energy levels and muscle function to wane, leaving you feeling too tired to do all the things you used to do and all the things you want to do. But MitoPure can help you turn back the clock. It's clinically proven to rejuvenate and invigorate tired, worn-out mitochondria for improved energy, muscle strength, and endurance. It's backed by more than 15 years of serious science. And I can tell you personally that my workouts have never felt more productive with noticeable gains in muscle and endurance within just a few months of taking it. And right now, Timeline is giving my community an exclusive 10% off your first order of MitoPure.

Just head to timeline.com forward slash Dr. Hyman, that's D-R-H-Y-M-A-N, and start your journey to peak muscle health. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there'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 resources.

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.

Hi, I'm Dr. Mark Hyman, a practicing physician and proponent of systems medicine, a framework to help you understand the why or the root cause of your symptoms. Welcome to The Doctor's Pharmacy. Every week, I bring on interesting guests to discuss the latest topics in the field of functional medicine and do a deep dive on how these topics pertain to your health. In today's episode, I have some interesting discussions with other experts in the field. So let's just jump right in.

ADHD is one of the classic examples of how important it is to look at the whole picture. Now, you asked me earlier in your intro, you covered so many such important topics about ADHD that I'm sure we'll get to most of them as we talk today.

The thing with ADHD, first off and foremost, is it's primarily been looked at as a medical model. In the psychiatric world, it's a medical model. Sometimes it's seen more as a behavioral issue, and it's treated with medication.

It's a brain disease. It's a brain disease. And as if you said before, the brain, it's really, it's a body disease that affects the brain. Yeah. Okay. And you've said that. In ADHD, there are some issues around the brain itself that make adults and children more susceptible to this inattention.

or their ability to fail at executive functioning. And the other piece is the self-regulation piece. And so you have this combination ADHD where you have self-regulation as an issue and you have the executive functions of an issue. And now it's been given this label, attention deficit hyperactivity disorder, and that's just a cluster of symptoms that everybody experiences to some degree in their lifetime.

Now, there's one kid in kindergarten that maybe he didn't pay attention once in his lifetime. He's a spy. I don't know what he's doing, but he's doing something where you have to pay attention all the time. And then there's the other person who they're so disabled by their ADHD, it's hard for them to work. It's hard for them to maintain a relationship and even marriages. And then everybody else falls somewhere in between.

And I think it's important to understand that piece, that it's a medical model.

And that when we see kids and adults, the other piece is that more and more adults are being diagnosed. And at least 4% of adults are found to have ADHD and maybe even more. I think we'll find out there's more as we go on. That they carry on the traits of the ADHD, they go undiagnosed. And then as they're adults, it becomes more prevalent as life piles up and their compensatory mechanisms become overwhelmed

All of a sudden, they're getting older and they're not eating right and they're not exercising, their ADHD becomes more prominent and then they come seeking help. And on top of that, we live in an ADHD culture where we're all driven to consume huge amounts of information by the addictive nature of social media and the internet.

And it literally is taking people who are not even ADHD and making them like that where they're hooked on their phones and they're constantly distracted and they're constantly getting the dopamine hit and it's magnifying it. And if you have ADHD, it's even worse. - Yeah. And here's how they come to us.

They come to us as families, as a mom or dad bringing a kid in, and they're discouraged. They're frustrated. The child is feeling left out. He's feeling alone because he's being labeled as a behavior disorder. He is unable to keep up in the regular curriculum in the school where you have to sit and get. And he can't sit and get.

right? He has to move around, he has to see pictures, he has to have creative illustrations, or she, you know, and it's, and that's how they come to us. And they've heard, oh, Johnny's so smart if you'd only work harder, you know? Susie, if she would just, you know, apply herself, you know, sometimes I think she's a little bit lazy, right? And they start to hear that language, and then they start to inculcate that as their own identity, right? And that becomes

in negative self-talk. That becomes discouragement. That becomes hopelessness for some people as time goes on. I mean, it's seen as a psychiatric disorder treated by psychiatrists. Yeah. And maybe it isn't really a psychiatric disorder.

-It's not. -Right? And in fact, most psychiatric disorders are not psychiatric disorders. That's why I wrote the book "Ultra Mind Solution" which is - -You even said it in that book, right. -Right, because the body affects the brain and the brain affects the body, the mind affects the body but the body affects the mind. And I think the cure for brain disorders is often outside the brain and I think that's what we're talking about here. Now it's actually becoming

part of conventional medicine. I recently interviewed for our podcast, an expert in nutritional psychiatry and the microbiome and psychiatry from Harvard. Another one who was in Stanford studying metabolic psychiatry.

So, we now know that there are so many factors influencing our brain function that have been ignored by psychiatrists and they're using psychiatric drugs like stimulants, like Ritalin to help people focus but it's just like pouring

you know, water on a fire with somebody else pouring gasoline on it at the same time, you have to get to the root causes. Right. And which, yeah. And I know we're going to get to the root causes, but one of the things I just really wanted to mention is in that discouragement that parents come and they say, you know,

They're worried about their child's performance. And even adults who now have piled up failure after failure after failure because of their inability to really deal with their ADHD, and they didn't even know they had it. I had a patient, she was 40 years old. She came to me because she saw one of my nurse practitioners. And my nurse practitioner said she wants a refill on her Ativan, but she...

I'm uncomfortable giving it to her. And because she was a new nurse practitioner, I said, well, let me see the case. I saw the name of the patient. I saw that they were coming to get their Ativan again, and they had a gap of using it. So I said, you know what? Schedule her with me. And she said, you know, I use it because I get overwhelmed.

I said, "What do you mean overwhelmed?" - So it's an anxiety medication. - She takes it because she gets anxious and overwhelmed. I said, "Well, what do you mean, oh, I get anxious? Well, what do you mean by anxious? I get overwhelmed. What does overwhelmed mean?" And she started to describe all the symptoms of ADHD, right? And she's a teacher. She was 40 years old. I took her through the DSM-IV classification

And then she went on to get a diagnosis. That's a psychiatric manual for how we label people. How we label people. With different mental illnesses. I used it. By symptoms, right? I did use it. I'm sorry, but I had to. It's good to sort of get a label. But I always say, just because you have a label doesn't mean they know what's wrong with you. You don't know the cause of your depression or ADD or whatever is going on. So I told her, you know, we did it. I said, you have ADHD. She was devastated. She was truly devastated. And, you know, she came back in tears, uh,

Because one, all the regrets, like why didn't I get diagnosed sooner? And then the denial, maybe I don't really have it. Maybe there's something else wrong that can be fixed easier. Anyhow, it's like now eight years later and I run into her because we're friends and she got an ADHD coach. She did take Adderall for a short period of time. I got her to work on her nutrition, so forth and so forth. She's doing amazingly well. Amazingly well. But-

- The point I wanna make is that ADHD can be a really devastating experience. And one of the things that I like to do when I'm working with my patients, this is the first thing we do. We've gotta normalize it. We gotta let you know everything's gonna be okay. - Well, that's right. There's a stigma, George, around mental illness. And that's really why I wrote the book, "Ultra Mind Solution," because it's very clear to me seeing patients who I would treat their biology,

and their psychology would get better. And I wasn't treating their brain, I was treating their body and I would notice the "side effects" of their ADD going away, their autism getting better, their depression going away, their panic attacks going away. I'm like, what is going on here? So that really through the lens of functional medicine, what we do here at the Ultra Wellness Center in Lenox, Massachusetts where we practice, is we go deep into these root causes.

So, with ADHD, what are the things that are the most common drivers? Because it's not a Ritalin deficiency as we said, right? It's something else. Yeah. What are we seeing in these patients that we find that then we can treat and help them get better? I start with the understanding.

- That there are some structural differences in the brains of a person with ADHD. - There's a predisposition. - Yep, there's a predisposition. It's genetic, it's physiologic. And so you can't ignore that starting point. Now, that's not the first, you know, so that's my first line of thinking. And I know that I'm going to find out what that is. - But it's important to remember for people that,

Genes load the gun but the environment pulls the trigger. - Right, exactly. - So you might have a predisposition, it doesn't mean you're predestined to have the problem. - Exactly, and that's exactly right, Mark, that's the point and that's where I go next is, like I know the predisposition is there and I have tests that I can figure out what some of those predispositions are actually expressing themselves in that child or adult.

I will address them. But I also, as you just pointed out, is I go back to the environmental pieces first. And because those I can start working on at the very first visit. - You can modify. - Modify at the very first visit without having to do any tests. And that is to go through lifestyle. And where's the first lifestyle piece I go to? It's nutrition, right? And because the nutrition

- Does a couple things. There is the nutrition, the actual macro and micronutrients and minerals and phytonutrients that the child needs that they might not be getting. And then there's the impact that that diet he's on is having on his body, particularly on the gut microbiome. - On the bad diet. - The bad diet, right? Which is filled with all the things that you talk about all the time, the high fructose corn syrup,

the GMOs, the hormones, the pesticides. - The additives and colors and dyes. Those chemicals have been linked in research to ADHD issues. - Absolutely. - Really clearly. - Yeah, and there's a diet, the Fine Gold Diet is based on removing those from the diet. So I can modify that right off the get-go and I can get them to start to think about how to change that child's diet and simply remove some things, right? And add some things in their place

to start moving them in the right direction. - And the diet you're talking about that they're getting usually is an inflammatory diet. - Yes. - And what's fascinating to me as we start to look at the research on all these brain issues, whether it's autism or ADHD or Alzheimer's or depression,

inflammation in the brain. - Yeah. - And we never knew that before. - Yeah. - So do you take an Advil if you have depression or if you have ADD? No, you have to figure out why there's inflammation in the brain and that's what functional medicine does. It's a methodology to get to the root cause of whatever it is and in this case it's inflammation in the brain and all these kids often have other inflammatory issues too and you have a case and I want to share a case where we talk about this but how do we

do we sort of begin to tease apart what aspects of the diet are the most important in these kids? First, I interview. Like I ask. To tease it apart, you have to ask like, okay, what mom, what are you feeding? And I'll ask them, right? And as soon as I ask the child what they eat, here's what happens. I'm going to just pick this up. Mom's holding a folder or a newspaper or something. And as I ask the child what they're going to eat, I see this.

Okay. I usually see she's going to hide because she knows what's going to come out. Right. We're going to hear about, we're going to hear about lucky charms and we're going to hear about hot pockets and we're going to hear about, you know, the Gatorade and, and flaming hot chips. And, and she, she's, she's doesn't,

She feeds the child that because that's what the child wants to eat. And because they can't self-regulate, she knows that there's going to be, you know, there's hell to pay when you're not giving them what they want. So yeah. So first off, you tease it out by doing a three-day diet history, talking to the mom, talking to the child.

And once you begin to tease that out, then you can get an understanding of what you need to add back in. And most of the time it's like everything, you know? - We also do food sensitivity testing, including for gluten and dairy, which often causes inflammation in the brain for these kids, right?

You know, I don't know when you want me to talk about the testing piece, but the thing I want to say about the gut microbiome in your diet is that inflammatory diet. Remember, and you don't have to remember, but for our listeners, that the gut microbiome does things for us. It's like another organ.

And so 70% of our serotonin resides in the gastrointestinal tract. - Like a second brain. - Right, a second brain. 30% of our dopamine resides in the intestinal tract. When you're eating a bad diet and you're shifting the microbiome, you're shifting the balance of good bacteria and bad bacteria,

You're now going to create an environment where a child cannot produce some of those neurotransmitters. You're going to create an environment where they're not breaking down their food completely. Because of the inflammation, you could be getting something called leaky gut. And that dysbiosis, that leaky gut, that leads to a lack of absorption of some really important nutrients.

And that begins to have a big effect. So now they're not absorbing their magnesium. Now they're letting too much copper in and not enough zinc. Now you're not getting enough iron. And we know that if you're anemic and you don't have enough iron, you're going to not be able to concentrate well. That's the real important impact of your diet. It's not just, oh, sugar's bad for them. Well, what's it doing anyway?

to, you know, you may notice that after-- - The microbiome. - The microbiome. - Yeah. - We gotta fix that. And that's why I said, I know what the predisposition is, but the first place we're gonna go is to the lifestyle and what, 'cause that lifestyle's affecting the most important thing and that's the gut. - Yeah, nutrition is so huge. And we see this with these kids is they have poor quality nutrition. They're eating a lot of processed food. They're not getting the good nutrients they need. They're eating foods that are inflammatory. They're having gluten and dairy often, which can be very neurotoxic for some kids.

They're eating additives and chemicals in their food that can trigger hyperactivity. And so there's this whole range of food interventions that have been shown to be very effective for these, because even removing food sensitivities, that's one study published in the UK. So there's a lot of literature on this. But again, it's not something that you get when you go to the psychiatrist. It's not mainstream. No, they don't talk about this. So we're looking at

- The role of nutrition. Nutritional deficiencies, food sensitivities, and lack of the right nutrients. What are the other things we should think about? The gut, you said. The gut plays a huge role, right? - Yeah, yeah. - So you have leaky gut.

Yeah, everything I just mentioned. With the leaky gut, the alterations in the microbiome, you're going to have less serotonin made, less dopamine made. You're not going to get the nutrients that we just talked about. And so that we look there and we can do tests to determine. We have very sensitive tests that can look at, we do organic acid tests that can look at amino acid levels.

which are the precursors for making your neurotransmitters. So that if you're not eating enough protein, which kids don't eat enough protein, you're not eating enough protein, and then you have already disordered your microbiome, which includes your gastric acids, which includes your pancreatic acids. Those are very important for breaking down your proteins, your carbohydrates, and your fats. You get all the nutrients you need.

So we need to make sure that if that's not happening, they're not getting their amino acids, then they're not going to be able to make those neurotransmitters. We can measure that using organic acids. We can look at carbohydrate metabolism that's important in energy production, energy that's needed for

the body to work, particularly the brain. Yeah. Since it has the most mitochondria in the entire body because it needs the most energy. And if that brain's not making energy because you're not getting the appropriate amounts and the types of carbohydrates, that child's not going to do well. Yeah. And we can determine that on,

the organic acids or an ion profile. - These are kind of tests you don't normally get at a regular doctor. And these tests tell us about things like mitochondria. You mentioned mitochondria, I just want to sort of loop back on this because there's a woman named Suzanne Goh, a pediatric neurologist, went to Harvard, Oxford and studies autism and she's found in these autistic kids, there's a subset of these kids that have impaired mitochondrial function in their brain

And it's an energy deficit which can cause these neurologic symptoms. And so she provides the substrates or the basic building blocks for making energy

in these kids that are supplements like CoQ10 and carnitine and other nutrients that are so important for building energy in the system. So we sometimes find this in these kids, they have energy issues. - Absolutely. You know, we've seen that with our autistic kids that when we give them, you know, those, we give them amino acids. When we give them methylcobalamin,

which is a basic nutrient, yeah, you see changes in how they... Dramatic changes. Dramatic. When you address the mitochondria, you're going to see those dramatic changes. And they also have issues around toxins, these kids sometimes, right? Yeah. So talk about toxins and mental health and particularly ADHD. Right. So...

The toxins that we look for the most, and they're tested for in schools as part of your- Lead. Lead. There you go, got lead. So we have lead. We also have mercury and we have arsenic. Yeah. Those are three very common heavy metals that you're going to find in your environment. So those, each one of them are going to be able to block-

the energy producing pathways in cells. They're also going to limit the metabolism neurotransmitters in the brain directly. They're directly neurotoxic and they also have effects on the body's ability to make energy in their mitochondria. So we test for heavy metals in kids all the time. And why do kids have that? And why do we find that? Because

I tell people, it's not a matter of whether you're toxic. It's not a matter of whether you have heavy metals, it's how many do you have, right? And how much. And that's gonna be a product of several things. Why don't we go back to genetics? You just may not be a good detoxer, right? You may have SNPs, which are single nucleotide polymorphisms. Those are like one single nucleotide change in the blueprint that makes the protein.

And if that is off, then that protein's not gonna work correctly. Well, if your detox proteins and enzymes are not working, you just don't detox that well. And we can determine that. And then we can determine what your lead levels are, and then we have ways that we can bring those down. - And it's so common, you know, I remember this kid I had who was like 10, 11 years old, just a terror, ADD, getting kicked out of class, disruptive, behavior issues.

And the mother was just desperate. I wasn't in your class. She was a young mother, but she was very smart and she kind of came to us. And it turned out he's school was across the street from a cement plant.

And the cement plant burns coal and coal releases mercury and lead. And every day they go in the parking lot, at the end of the day, the cars were just dusted with this ash from the cement plant. And the kids were playing in the playground with the cement plant. And I tested him and he had very high levels of heavy metals. And we detoxified him, we fixed his metabolic pathways and this kid got better. So, you know, it's not

Not that every kid with ADD has lead or mercury. It's just one of the things to think about. And just like I always say with functional medicine, just because you know the name of the disease doesn't mean you know what's wrong with you, right? ADD can be many, many things and many, many factors. It can be gluten, it can be metals, it can be nutritional deficiency, it can be magnesium issues, it can be your gut microbiome, it can be gluten. So you have to think about all the factors.

I want to take a moment to talk to you about something I believe in and I'm passionate about. If you're a regular listener, you already know how vital gut health is to living a healthy hundred years. But after years of being asked which probiotic I recommend, I'm excited to share that I've joined the Clinical Board of Seed Health, the microbiome science company behind DSO1. It's the one probiotic I take every day and recommend because it's truly a game changer.

DSO1 combines 24 clinically and scientifically studied strains in a pomegranate-derived non-fermenting prebiotic that our gut bacteria biotransforms into beneficial metabolites like urolithins, which you've probably heard me talking about for their role in cellular health and healthy aging. DSO1 has a multitude of evidence-based benefits from promoting healthy regularity and easing bloating to supporting gut immune function.

gut barrier integrity, glowing skin by the gut-skin axis, and heart health via the gut-liver axis. Yep, everything is connected. One of the reasons DS01 is so effective is Seed's patented capsule-in-capsule technology, which protects the viability of probiotics for a precision release in the colon where probiotics matter most. I've been following Seed Science for years, and I know the founders personally. I admire their dedication to setting a new standard in probiotics, and I recommend Seed's DS01 as a non-negotiable in our daily health regimen.

I'm excited now to be on the journey with them and offer my community 25% off your first month of DS01 with the code 25HYMAN.

you got to go to check out OneSkin. Use the code HYMEN15 at OneSkin.co for 15% off your first purchase. Again, that's OneSkin, O-N-E-S-K-I-N.co with the code HYMEN15. From your perspective, what are the fundamental causes of this acceleration in brain inflammation? And let's start to 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

or walking pneumonia, where the body is actually inflamed and 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 2% that can get,

leakage of solutes, et cetera, that'll go through the brain. Then after that, what happens is you have these, what's called microglia. It's part of the CNS, it's called glial cells. And microglia gets activated. And what microglia- That's the immune system of the brain. Yes, for the brain. And microglia acts, like I say, it's like a cleaner. So it's coming in to help clean out 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- - Those are cytokines. - Those are cytokines, yes. - I heard about the cytokine storm from COVID. These are bodies, immune messengers that

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

it 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,

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, you know, 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, you know, I felt physiologically depressed and

and, 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 ticks. 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, 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. So 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 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...

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, an inflammatory hormone.

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, gut issues, headaches, anxiety, 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 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 vitamin D do you need to not get rickets? Probably 30 units. How much do you need for optimal health? Maybe 3,000. Right?

Yes, 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. 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 nutrition.

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

People don't realize that. Antioxidants, things for the mitochondria. People don't realize that. People don't realize it. 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 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, NMDA receptors.

when you look at even vitamin D, vitamin D has shown that people that have autoimmune conditions or chronic disease conditions, the lower their vitamin D levels are, lower than 40, the worsening of the actual symptoms. Their symptoms are more pronounced.

And so, 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 it's

this model of functional medicine psychiatry is actually a profoundly effective model for treating mental health issues if people understood what to do and 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 you know

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, 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 vitamin D. Exactly. Yeah, and so you want to look at those other nutrients like RBC zinc, RBC magnesium, all the core nutrients that you can do. 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. I was in practice when you asked that question, I started seeing a

a group of a lot of kids that would come in every time the season changed.

And histamine-- - We're worsening psychiatry. - Yeah, we're worsening psychiatric systems. 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 all these mood changes, increased anxiety, and for many of those patients, I might just say, hey, get on antihistamine, or natural ones would be things like quercetin, stinging nettles,

And so that will actually help because they become less inflamed. So you'll see like when someone is having, 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.

It increases epistamine, it causes brain fog and focus. It can cause mood changes. So there are so many pieces like environmentally. - I also had that, yeah. - Yeah, me as well. I also had Babesia like you. - Oh my God. - So I'm laughing when you were speaking 'cause I'm like I've had all of those two, Lyme, Babesia. And Babesia is one as well as Bartonella that affects the neurological symptoms, so with symptoms. 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

I'm not actually, should be anxious or stressed out. And so that's the story. - A 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 it's it's um it's sometimes important to dig and you know 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 right 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 and so

You mentioned a lot of them in your talk around infections. We talked about toxins, poor diet, stress, trauma, and even aging itself 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...

What outcomes are you seeing when you start to treat a patient? Maybe you can share some cases to sort of make it more real for people. Because I think it's abstract a little bit. I mean, 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. 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 one point.

you know, 40 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 100? 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, 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 back on the protocol as well as like immune modulation, you could just see the numbers all cleared out. So I'm looking at it as what are the things that are triggering up inflammation, which are making these things that are like underlying actually get worse. And then looking at that in its entirety 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- All of it.

Not everything's lime, not everything's mold, not every, yeah. Like how are you making sure to be open to, um, other causes? Because I've even had, uh, one of my interesting cases, a patient with RA, um,

Wasn't treated and didn't get worked up for tick-borne diseases. Worked on that, already 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? Like, what has happened? And sure enough, it was like 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, you know, 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 like 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, you know, stress either exacerbates or causes like 95% of all illnesses. And, you know, whatever is going on, it's going to magnify it and increase your inflammatory state. Exactly. And, you know, in your talk, you really went deep into understanding how neurotransmitters

the brain messenger chemicals get dysregulated by various insults.

All the things we talked about, you know, poor diet, stress, toxins, allergens, gut microbiome, you know, 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. These are tests we can do through a regular laboratory test, 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

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 gets lower. - Exactly, it'll go lower as those inflammatory markers increase up. So it kind of shifts the whole balance. So we need a little bit of each one. I always tell people, it's like 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 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

- 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, it's 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 to inflammation.

of concern when it comes to neuroinflammation. - Yeah, so you can see that sort of a sign of B6 functional deficiency. - As well. - And that is B6 is required to convert tryptophan from your diet into 5-hydroxytryptophan and 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 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, or there'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-inflammatory, 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

kind of comports with what we're seeing in our society, which is just 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 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, 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. And we didn't have this when I was growing up. It wasn't like every day or every week there's a new shooting in some school.

and the level of just sort of oppositional behavior and anger and hostility. And I mean, it's like, you know, I have a social media account. I just like sometimes I put stuff up that's sort of benign and you get 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's, you know, 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 sort of

from doing 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, yeah. - The adult in the room gets disconnected from the ancient limbic reptile brain. And there's this weird disconnection that happens so the adult is gone. And so it's like, we call it the amygdala hijack, which is the 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 phenomenon 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

you know, would kill anybody or do stupid shit. So what is the science behind that? Can you unpack that? And also the trauma. Like when you look at kids, what they said have shown the trauma from all these events like 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 they know their brain's not fully developed. The grown up in the room is not in the car. It's not actually going to be the one driving, right? 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 like significant depression or anxiety, you'll see like a lot of memory issues, like flightiness for people with anxiety, brain fog, forgetfulness.

Yeah. We even call it pseudodementia. When 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 anxiety, and that's what controls emotions and that piece with the nine-year-old driving the bus versus 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, 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 will all, 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 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 result like you're having less your body's constantly needed push out dopamine for everything with technology. One example I had, it was great because I did a urinary test and I was trying to get the person I was actually working with someone that I didn't know was a big gamer. And so 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. And 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. Her dopamine levels were high, norepinephrine, epinephrine, cortisol was through the roof. So of course she's going to 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 going to be able to focus in class. Of course, they're not going to be able to emotionally regulate as well. So all of those things have these like kind of added effects that can cause issues, but definitely technology with dopamine and

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.

And one of the whole things is that, you know, we mostly eat a standard American diet. You've done a lot of work on this over the course of your career, Mark. And I think that it has shifted the needle. But for the most part, many Americans are not eating whole foods. They are really tapping into processed, ultra-processed, junk foods and fast foods.

60% of our diet is adults, right? That's huge. It is huge. And then a lot of, we talk about colors of the rainbow, but the truth is in my book, I really dove deeper into the micronutrients and broke down what these nutrients are that people should be. And I call it a kaleidoscope of colors because it's much more than just the rainbow. And if we actually understand that these foods we can lean into are offering us so much value,

we will actually start to improve, even start to turn that needle on how we're eating. So we need to magnify those micronutrients and prioritize those healthy fats, but also avoid those anxiety-triggering foods. I think that what tends to happen in this country is that people fall into what we have is the diet culture and the eat this, not that cultures. Take, for example, the ketogenic diet. It has

excellent results in certain conditions of mental health. Right, it's not for everybody. But it's not for everyone because we work out of Massachusetts and I trained and did some of my work in group homes in Massachusetts and individuals who live in a state-aided facility are given sliced white bread. They don't have a choice to choose a better, healthier. So we've got to

tweak this and even from experience in my own clinic, it has to be personalized to the individual much more than it used to be. And some of that is, you know, stuff that you and your audience already know, the fine tuning of the microbiome and the fact that there is certain, we now know there are certain, you know, lactobacilli, like lactobacilli rhamnosus targets anxiety through GABA receptors. So now that we're learning that it can be, you know, different points of target.

Yeah, well, there's a lot in there. We're going to have to unpack all that because it's really important. All the foods, the things that harm you, the things that help you, the things that you can use to upgrade your microbiome to actually improve your mind. Actually, just to sort of jump on a tangent for that for a minute, I have been studying a lot about acromantia, which is a really important microbe. And it's sort of one of the keystone microbes in your gut, and it protects the lining of the gut from

being damaged, prevents leaky gut and inflammation, regulates immunity. But a woman who I know who has a company called Pendulum Therapeutics basically has been

able to culture and grow acromantias, the first probiotic company to do this. And what she said was they were growing it and they noticed there was, they were sort of analyzing what was in the soup. Basically they grow it like in a, in a kind of a microbial stew and it grows these bacteria, but bacteria, people have to understand that in your microbiome are

are not just bacteria, they're producing all sorts of molecules. Their DNA is just like our DNA. They're expressing proteins, they're expressing molecules, they're producing metabolites. In fact, probably a third of all the metabolites in your blood come from the microbiome metabolites. And she said what was so shocking was that they found extremely high levels of GABA in the soup.

Meaning, this particular microbe was spewing out basically this anti-anxiety neurotransmitter. It's something that our bodies make. And when you take Valium, that's how it works. It actually works on the GABA receptors. So it's like a body's natural Valium. And it just, this kind of speaks to the kind of paradigm shift. It's like, wait a minute, how does a bacteria in your gut affect your mood?

affect your anxiety level, maybe cause depression or inflammation. Now we're looking even at the brains of people who died, for example, of depression. And we can do autopsy studies or we can do neuroinflammation studies with imaging. And we see there's high levels of inflammation. So people don't think that, oh, I'm depressed, my brain's inflamed. But it actually is. When you look at the amount of inflamed emotions in this country,

Whether it's anxiety, whether it's divisiveness or the aggression or polarization or, I mean, the stuff that people put out on social media just shocks me. I mean, it's like they hide behind anonymity and people have this sort of pent up level of aggression and hatred and violence and

It's incredible to me. And I think we don't connect that often to what we're eating or to our overall health. And I think this is such an important part of the work that you're doing is you're highlighting these connections for people. You're helping them understand this is not just woo-woo science or woo-woo medicine. This is really deep science that we're now learning about these connections.

This is exactly where it's at. And I think that, you know, inflammation was seen very differently when, say, I was first studying in medical school and it was part of psychiatry training. It was not something that you were taught.

but inflammation has burgeoned forward as we understand the gut microbiome and that science. And we now see studies that link inflammation to conditions like depression, anxiety, cognitive disorders, and more. And one of the things that I thought was really interesting is that, you know,

And SSRIs have actually, they're not my favorite medication, but they actually have been shown to have an anti-inflammatory effect. So it makes me think, well, should we be looking at medications that are anti-inflammatory to be treating these conditions?

And I happen to think that a lot of that fine tuning of the science can actually be around the gut microbiome. Like you said, you know, finding where the GABA is produced, where it's hanging out and other cool things that, you know,

that are related to anxiety like lactobacillus plantarum influences dopamine and serotonin levels. So the more we know, I think the more that we can use that's not necessarily a prescription medication. So instead of Prozac, we're going to be prescribing personalized microbes that are targeted at your particular issue, right? Yeah. It's interesting. Which is exactly, which is

The direction of psychobiotics, right, which we hope. Psychobiotics. This is a great term. Psychobiotics. What is a psychobiotic? Does it turn you psycho if you eat it? It's kind of not the best word. You're absolutely right about that. But, you know, it's an emerging field of research where what we basically are trying to do is

You're using beneficial bacteria like the ones we've talked about, for example, or support for some of these bacteria. And support can be in the form of a prebiotic that influence bacteria brain relationships. Right. So psychobiotics exert anxiolytic and antidepressant effects characterized by these changes. Right. And so.

I'm very excited that maybe that's a direction mental health should be moving in because it would be using the basis of food as medicine, but then taking the deeper science we're learning about Acumencio or whichever lactobacillus it is and more to actually offer treatment through those mechanisms while also, of course, adjusting the diet, right? Yeah. Yeah.

I think this is important because I think a lot of the ways that the gut mediates disease in general, not just obviously the diseases of the mind or the brain or however you want to think about it, but inflammation is driving heart disease, cancer, diabetes, Alzheimer's, obviously autoimmune diseases. It's the singular biggest driver of almost all disease. But until now, we hadn't realized it was connected to

to the brain in terms of its expression of mental health disorders. And now I think we're really understanding this. And again, it's not, like I said, it's not just depression, anxiety, it's all kinds of things. ADHD, autism, OCD. I mean, you know, it's quite amazing. Aggression, behavior issues. And the food is such a biggest driver. And in weight

Part of the way that food mediates inflammation is by changing the microbiome because guess what? You're feeding that whole garden of bugs in there that lives and thrives on what you're eating or you're feeding it stuff that's actually turning it into little zombies that are

causing inflammation that are basically destroying your health. So this is a really important sign of discovery. And I think, you know, we often get sidetracked. We go, oh, wait, inflammation seems to be affecting mental health disorders. So I read a study that, like, made me want to, like, vomit and tear it up and burn it, which essentially said that we should be using TNF alpha blockers to treat depression. Now, these are drugs that are used for autoimmune disease. They cost $50,000 a year. They have

significant side effects, including immune suppression, increased risk of cancer. And scientists are going, well, yeah, inflammation in the brain, let's treat them with anti-inflammatory drugs that basically like shut off the inflammation. Let's use chemotherapy to treat depression. I'm like, wait a minute, this is crazy and not focused on what we should be doing, which is what you really are focused on in your book.

Well, I appreciate you saying that, Mark, because, you know, I started joking about, you know, another use for anti-inflammatory medications and that kind of stuff. But in reality, I think that we have this backwards, and that's what the Buddhist medicine movement is trying to reverse, right? Because we're practicing defensive medicine. It's always pulling out a prescription pack or electronic prescription. It's not looking. And you've pioneered things like functional medicine along with other people. So I feel like we have it backwards.

And now we're trying to catch these diseases and the level of inflammation and the level of metabolic disruption and fix it. And it's hard. It's just hard to do. Yeah. I mean, it is. And it's the inflammation. And it's also the changes in the neurotransmitters that happen as we eat certain foods. So when we eat sugar...

We see, or starch, we see, and even oatmeal, which we think is a healthy breakfast, shows an increase in cortisol and adrenaline. These are your stress hormones. So literally, you have a bowl of oatmeal and your body thinks you're in fight or flight and fighting from a tiger. And this is driving more health consequences.

And making you feel more stressed. It's driving health consequences and it's driving stress. You're actually right. And not many people realize that because I was trying to comment on this one immediate piece recently that it's really, it's marketed as this healthy breakfast. And once in a while, if you're to have it, okay. But, you know, this should not be

what we're eating but it's a lot of changing a lot it's changing how we think you know so when the when the um gut microbes are basically involved in how they break down food you also get the synthesis of different neurotransmitters that are modulated by this gut microbes so how we feed them is so important because they're

their actions like the short-chain fatty acids and the bile acids, some of the studies have shown that the metabolites produced by the gut microbiome now include things like the neurotransmitters, GABA, you mentioned, serotonin, dopamine,

But they also, you know, they, some bacteria encode genes for specific enzymes that can catalyze the conversion of substrates into certain neurotransmitters. So it's going much deeper now. And, you know, my only point being that, where does it start? It still starts with how we're eating. So if you are

Heading to the fast food restaurant every day, you are feeding the wrong microbes in the gut, right? And then their breakdown product is going to be toxic. So unpack what you just said, because I think you skipped over pretty quick, which is that when you're eating certain foods, you're making differential bugs grow. And it's not just the neurotransmitters that are produced by these bacteria. It's also other metabolites. You mentioned short-chain fatty acids. Can you explain what that is, why it's important, and how it affects mental health?

Sure. And why we're all starving, why we all have very, very low levels of these short-chain fatty acids. So the simple way to say it is that when we consume different foods, especially healthier foods, the gut microbes basically break down...

break down the foods. But one of the things that we want them to be producing are the short chain fatty acids. And these are actually good products for the brain. They are good products for mental health. And there are a subset of fatty acids produced by gut microbes during the fermentation of

partially digested polysaccharides. And the highest levels of the short chain acids are found in part of the large colon. And they actually, in

interact with enterocytes and are transported across the single cell lining of the gut. They have been associated with, you know, they've been, and by the way, they have names, they are acetate, propionate, and butyrate. And we want the formation of these short-chain fatty acids to help our mental well-being.

What tends to happen is the opposite of that. When we're eating the standard American diet, the breakdown products are toxic metabolites that start damaging that cell lining of the gut. And over time, not immediately, but over time, not only set up inflammation and dysbiosis, but

start to damage that lining and you develop things like leaky gut, intestinal permeability. So the more times that we're eating that, those kaleidoscope of colors, the healthier foods, we are building up the short chain fatty acid production. And we know that this affects our neurotransmitters.

So do we have an understanding of what, when you just said that certain foods produce more toxic metabolites, what those metabolites are, what the mechanism of action is, and how they work to influence our health, and particularly our mental health?

What I do know about it is that they are usually toxic metabolites that actually pierce that cell lining. They are formed. You mentioned foods like sugar. So the level of high fructose corn syrup and added, you know, we know there's a repository of about the last time I checked, 262 other names for sugar on food labels. So we actually are consuming sugar.

so much more sugar than we ever did, right? And one of my favorites is brown rice syrup, and people think, well, brown rice is a healthy grain, but brown rice syrup, as you know, is just sugar. So there's all this trickery going on, and we're consuming all the sugar. The sugar, the breakdown products are very damaging to that cell lining and really produce a toxic byproduct compared to a healthier short-chain fatty acid by the good microbes. Yeah.

And also when you fertilize bad bugs and you eat junk food, they produce also a compound called lipopolysaccharides or LPS. These are endotoxins. These are literally poisons produced by the bacteria that get absorbed across the lining of the gut and trigger your immune system to say, hey, this is bad news. It's actually what's produced when you have a bacterial infection and your body

is trying to fight it, your immune system goes to attack these lipopolysaccharides and it can create insulin resistance, obesity, weight gain, mental health issues, brain inflammation, as we discussed.

Really important. I think that this topic is just beginning. We're just learning at the frontier of what's going on here. We're going to be able to really understand how to modulate our microbiome differently. We're going to understand what psychobiotics are and how to use those instead of psychiatric drugs maybe to treat mental health issues. And I think speaking of this sort of short-chain fatty acid topic, I'm just going to sort of dive into that for a sec because it reminds me of a study that –

I found on breastfeeding infants versus actually bottle fed infants. And just to kind of back up on this, you mentioned butyrate and acetate and propionate. These are short chain fatty acids and propionic acid in high levels can be toxic. And in animal studies, they've literally injected this into brains of rats and it makes them autistic. It literally makes them autistic.

in very short time. And when I looked at the study of breastfed versus bottle fed babies, you know, 30, I think 35% or 25% of breast milk is something that's completely indigestible for the baby. Now, why would nature put in a third of the calories or the information in the breast milk that the baby can't absorb? It's food for the microbiome. And so when they actually

were consuming breast milk, these oligosaccharides were fertilizing good bacteria and causing a high amount of butyrate, which is anti-inflammatory, prevents cancer, helps regulate your immune system, and helps feed the lining of the gut and many other things. When the babies were bottle feeding, they didn't have these oligosaccharides in them. And these babies end up having extremely high levels of propionic acid and a higher risk of autism and neurodevelopmental diseases.

Now, I'm not saying you shouldn't breastfeed, I mean bottle feed. I think some people have to bottle feed. But now they're actually upgrading these by putting these oligosaccharides in them, by putting DHA, because it's like, "Oh, it's just milk." And changing the formula. Right. Yeah, because we didn't even know we were leaving out and it was causing all these consequences that we're seeing. So I think this is such an important thing. It's affecting not just depression, but all these mental health issues that are so challenging.

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 Pharmacist.

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.