Transform Your Mental Health With Diet & Lifestyle | Dr. Chris Palmer

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology at Stanford School of Medicine my guest today is Dr Chris Palmer Dr Chris Palmer is a psychiatrist and researcher at Harvard University he focuses on how metabolic health and mitochondrial Health in particular can be leveraged to treat and in some cases cure psychiatric disorders including schizophrenia autism depression bipolar and ADHD today we discuss how metabolic Health something we hear a lot about nowadays is really about mitochondrial health and the specific lifestyle and other factors that you can use to improve mitochondrial number and function we talk about things like exercise sleep sunlight which you've heard about before but we talk about those from a different perspective and we discuss some things that have never been discussed before on this podcast at least in light of mitochondrial health things such as creatine methylene blue nicotine and we talk about the key role of specific B vitamins and iron in brain function we also have a very direct discussion about vaccines and whether or not inflammation caused by vaccines can potentially damage mitochondria which then leads to mental health challenges and of course in that context we discuss the vaccine autism debate we also discuss public health and what is needed to truly change the way people exercise and eat and the rapidly changing landscape of the National Institutes of Health and the CDC as you'll soon hear Dr Palmer gives us a master class on mitochondrial function and how to improve this vital aspect of our health if you've heard about metabolic Health you've heard about the Obesity crisis that's important but looking at all of that and approaching it through the lens of mitochondrial Health you'll soon learn is absolutely the way to go it's a New Perspective that will change the way that you think about mental and physical health and that no doubt will impact your health practices in very positive ways before we begin I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford it is however part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme this episode does include sponsors and now for my discussion with Dr Chris Palmer Dr Chris Palmer welcome back thank you so much for having me back I credit you with leading the Call to Arms the public awareness and the implementation of what some people call medic olic Psychiatry but what we could easily just call the relationship between mental and physical health and the use of nutrition supplementation and where appropriate prescription drugs for the treatment of mental health but what do you call this field that you've basically founded and that you're pioneering there are others right but uh that you're pioneering and how should the general public think about the relationship between mitochondria and their Mental Health for for those that are not aware educate us I could talk for hours on this um so first of all thank you for um I I think you're actually giving me way too much credit though um I don't know about that I uh I'm I'm talking a lot about it and I think I will accept that maybe I'm able to talk about it in a way that helps people understand it that other scientists haven't been able to but you know one of the more important reasons I want to say this is because unbeknownst to a lot of people this field has actually been around for about a century and a half researchers in the 1800s around the turn of the century well up into the 1960s were hyperfocused on the role of metabolism in severe mental illness schizophrenia bipolar disorder they were actually measuring levels of lactate and glucose and um and other kind of metabol biomarkers in people with schizophrenia and bipolar disorder documenting differences really kind of H honi in on the these metabolic disruptions is potentially the cause of mental illness and then our field lost its way we we became focused on neurotransmitters and assumed that they were the primary cause of mental illness while other fields were focused on psychological and social social factors you know we got cognitive behavioral therapy we still had psychodynamic Psychotherapy um but people were doing research on adverse childhood experiences that was really taking off documenting that that's related and so you know the field kind of splintered into these biological psychological social camps um and people really hyperfocused in all of these ways to me this field of integrating metabolism with mental health with physical health is about unifying that whole story it's about unifying and building on what these researchers a hundred years ago were pursuing it's about integrating the biological psychological and social camps it's about putting it all together and stop being so reductive C istic and simplistic to suggest that it's all biological or it's all psychological or it's all social and that if one if it's one it can't be the other it can be all of them um and it's different combinations for different people so in many ways I'm just standing on the shoulders of giants who have done groundbreaking work to create the science that allows us to put this all together um with that said I do firmly believe that we are on the cusp of a revolutionary change in the Paradigm of the mental health field of how we think about mental illness you know there are Myriad biological things the psychological and social things are all obvious and true yes stress trauma loneliness adverse childhood experiences all of those things come together our field is long known that all of those things play a role in mental illness which exactly which mental illnesses it's essentially all of them every one of the labels in dsm5 can be impacted by biological psychological and social factors so trauma in childhood increases risk for posttraumatic stress disorder duh everybody knows that trauma in childhood also increases risk for neurodevelopmental disorders if it occurs early enough it increases risk for substance use disorders personality disorders psychotic disorders mood disorders anxiety disorders dementia later in life and everything else every label what else do adverse childhood experiences increase risk for all of the metabolic disorders obesity type 2 diabetes cardiovascular disease autoimmune disorders premature mortality you know we have statistics that just sticking with that theme adverse childhood experiences if you have six or more adverse childhood experiences compared to somebody who has no adverse childhood experiences now that's a rare group granted but for the people who have six or more on average they live 20 years shorter they lose 20 years of life because of those adverse childhood experiences and so is that a mental health issue I would say it's a physical health issue it's both it's both a mental health issue and a physical health issue and so how can we understand that how can we understand that trauma in childhood increases risk for heart disease and obesity and diabetes and dementia and PTSD and ADHD and sub use disorders and the only way to connect it is through metabolism and ultimately through mitochondria unfortunately people like simple answers and they're like so diet will fix everything I'm like no I never said diet will fix everything but it can help it can help and it can be lifechanging and life saving I I don't want to I don't want to minimize or step back from my work with dietary intervention there is no doubt in my mind it can dramatically change people's lives but it's not just diet it's lots of other things and um and so it's putting it together and trying to make sense of the science for what does cardiovascular disease have to do with depression or PTSD on the surface a lot of people scratch their heads and they really don't know they they assume that well one's a brain disorder and one a heart disorder and it's like no we need to integrate that because all of the risk factors this this essentially the same bioc psychosocial risk factors that increase risk for heart disease also increase risk for brain disease and we just we need to start putting it together we need to be more sophisticated we have computers we have ai it's 2025 we can do better yes well first of all uh I and I'm sure the listeners really appreciate your human regarding who's responsible for the uh big surge in uh the interest in this field um so thanks for crediting your predecessors and um the others in the field uh at the same time I credit you um with really popularizing a lot of these terms being willing to go public facing and and share about metabolic Psychiatry for lack of a better uh way to put it U metabolic Psychiatry and and and really championing these ideas and uh being open into being part of a medical and Science and public discourse community so I'd be remiss if I didn't say that so hopefully you'll take that in and if you won't then I I very much appreciate it it's true thank you very much it's true and and I'm not alone in in that sentiment I'd like to take a quick break and acknowledge our sponsor our place our place makes my favorite pots pans and other cookware surprisingly toxic compounds such as pases or forever chemicals are still found in 80% of non-stick pans as well as utensils appliances and countless other Kitchen products as I've discussed on this podcast these pases or forever chemicals like Teflon have been linked to major health issues such as hormone disruption gut microbiome disruption fertility issues and many other health concerns so it's really important to avoid them this is why I'm a huge fan of ourplace ourplace products are made with the highest quality materials and are all past and 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first thing in the morning I also drink element dissolved in water during any kind of physical exercise that I'm doing especially on hot days when I'm sweating a lot and therefore losing a lot of water and electrolytes they have a bunch of different great tasting flavors of element they have watermelon citrus Etc frankly I love them all if you'd like to try element you can go to drink element.com huberman to claim a free element sample pack with the purchase of any element drink mix again that's drink element.com huberman to claim a free sample pack if I think about a mental health condition like depression let's take depression um uh to start off I can just broadly create two you know Columns of of things or approaches that one might take uh one is this U mental model of sort of a molecule deficiency like I'm not saying this but there are many who at one point thought uh depression is related to a deficiency in serotonin or depression is related to a deficiency in dopamine either levels regulation enzymatic control whatever the the the level of control just this idea that these molecules are somehow lacking if you put them back you can relieve some symptoms of depression the other column that comes to mind for me having looked at the data on cognitive behavioral therapy on the data on uh psychedelics in the clinical setting for the treatment of depression ssris and other um so-called anti-depressants is this notion of neuroplasticity the idea that neural circuits can change and that neural circuits control our sense of well-being our perception of self perception of others feelings of agency Etc and it's now very clear that if you change levels of neuromodulators like dopamine like serotonin you don't necessarily cure depression but you open a window for plasticity and then perhaps the therapy that you're doing can modify brain circuits more robustly so I think in terms of molecule deficiency maybe it's a vitamin deficiency a neuromodulator deficiency and then I also think about plasticity that these treatments are just allowing for more brain change more rapidly what other columns would you add to that picture um and perhaps first do you think that picture is um woefully inadequate or just partially inadequate because I think this is the way most people think about the treatment of mental health they think oh there's something missing you take a drug and you get that thing back and then like ADHD you don't have enough dopamine or what you put it in and then all of a sudden attentional circuits work better this kind of thing versus plastic which is the modification of those circuits and the two things are not mutually exclusive but I I think until now they really hasn't been a a clear understanding that there are other columns for um for mechanistic change in in mental health I would say the concept of metabolism metabolic regulation mitochondrial function mitochondrial Health actually is an umbrella concept for everything you've just said it's an umbrella concept for well how do we create neurotransmitters where do these neurotransmitters come from what regulates their production release from cells and then even to go further what impact do those neurotransmitters have on other cells they are largely regulating brain metabolism and the way we usually think about it is they are regulating brain activity but if you ask the question well what is brain activity brain activity is either is fueled by metabolism that a a neuron cannot be active unless it has the capacity to increase its ATP kind of production and then when you suppress a neuron when you when you inhibit its function the TP production goes down so whether you want to think of metabolism as just a consequence of neural activity I actually think about it as an integral part of neural activity it's kind of like your car can't go without the engine a cell can't go without mitochondria um a cell can't do what it's supposed to do without mitochondria the other concept that you mentioned neuroplasticity neuroplasticity is all about energy and met metabolic resources to create new connections new neural connections between axons dendrites Somas other other aspects of neurons and cells and other types of cells asites oligodendrocytes um but in order to get neuroplasticity neuroplasticity implies growth and modulation and even pruning but it involves change and in order for an living organism to change that requires this foundational concept of metabolism now on the surface to a lot of people that sounds too abstract and it sounds like well that's ridiculous then if you're you're saying that metabolism is everything in biology and I kind of am of course it is you you can't talk about biology without talking about metabolism but when you talk about metabolic Health it becomes much more concrete pragmatic and real with real tools that you talk about all of the time on this podcast exercise promotes metabolic Health exercise promotes neuroplasticity they are inseparable you can't improve your metabolic Health without also at least opening up the opportunity for neuroplasticity improving your diet does the same thing sleep or lack thereof can impact this substance use can impact this and so you know in a way it it basically says let's connect all of the dots let's not hyperfocus on serotonin and a serotonin imbalance or deficiency as the singular cause of depression because for those of you who don't know that is ridiculously reductionistic and it is absolutely not true we know that we know that with certainty now you know the the whole serotonin hypothesis of depression came about not because researchers identified serotonin deficits in the brain that entire concept came from the observation that medications that modulate serotonin activity or inhibit its reuptake into neurons those medications ssris other types of anti-depressants those medications can reduce the symptoms of depression in some people that was just a purely serendipitous finding it was Serendipity the first anti-depressant was actually a tuberculosis treatment they were giving it to patients on a tuberculosis Ward and an astute infectious disease doctor noticed some of these patients are really depressed but when I give them this tuberculosis treatment they perk up like within a few weeks they start looking a lot less depressed and I don't think it's a coincidence I think it's the medication I'm giving them do you recall what the drug was aoide it's the first MAO inhibitor and um I could be saying the name wrong but uh it's first MAO inhibitor and uh that became the first anti-depressant which makes sense uh MAO inhibitors inhib of the enzymes that break down or let's just speak about these enzymes broadly either I think most anti-depressant drugs or treatments for ADHD typical prescription treatments uh either reduce the breakdown of neuromodulators like serotonin dopamine acetylcholine depending on which one we're talking about or they um they reduce the reuptake so that there's just more neurom modulator around for longer yes tell us about mitochondria in the framework of mental health so most people know mitochondria as the PowerHouse of the cell if if if they know that it at all so these tiny little organel and the PowerHouse of the cell reference means that mitochondria take the breakdown products of the food that we're eating they are the primary thing using the oxygen that we're breathing in they are creating the carbon dioxide that we're breathing out and that they are turning food into ATP which is the energy currency of the cell so they're taking food and oxygen and lots of other things but let's just simplify food and oxygen converting it into ATP and that is what the PowerHouse of the cell kind of refers to there is no doubt they do that there is no doubt that when that process stops humans have about six minutes or so and then we're dead that process is critical to life there is no other process in the body that you can disrupt that will kill the organism faster it is Central to living organisms this production of ATP so I don't at all mean to take away or minimize that function but research over the last 25 years has completely upended that simplistic notion of what mitochondria are doing they are actually doing so much more some people have created the reference that MIT are like the workers inside a cell that in order for a cell to work you need a Workforce because there's so much that needs to be done signals need to be sent thing like all this work all of these different things need to be functioning and mitochondria are absolutely providing the energy for those things to happen but they're also orchestrating a lot of it so for example they play a direct role in in converting food into some of the substrates for the production of neurotransmitters um but they also go further they store like some neurotransmitters like Gaba within themselves and that plays a role in gaba's release from a neuron they actually go to the cell membrane and move along the membrane dispensing vesicles of neuro transmitters and when you take the mitochondria away from the synapse but provide that synapse with ATP vesicles don't get released neurotransmitters aren't getting released the mitochondria are doing more we don't exactly know what but they're doing more than just providing the energy they they play a role in turning inflammation and immune cell both on and off they help start the process but they also help coordinate the cessation of that process they play an instrumental role in both the first and the last step in the synthesis of cortisol and they play a role in the first step in the synthesis of all of the steroid hormones which include estrogen testosterone progesterone so that if you have disregulation of cortisol or if you have disregulation of testosterone or estrogen or progesterone you must understand the role of mitochondria in that disregulation because they are critical in the production and release of these hormones they are the primary regulator of epigenetics so epigenetics are the expression of genes from the cell nucleus and researchers have long known that that's related to levels of reactive oxygen species it's related to levels of calcium it's related to other cell signals those cell signals are mostly originating within mitochondria during the development of any cell mitochondria they are like a universe unto themselves and there's so much we don't know about them but what what researchers have found is that mondria actually line up literally line up in an organized fashion around the cell nucleus and take on different confirmations and that is somehow sending signals to the Gen to result in the expression or the suppression of different genes from the nucleus and that when researchers take these mitochondria and like mess them up or something the cell does develop normally you know they've been implicated in all of the phases of the human stress response to psychological stress so that includes cortisol release noradrenaline release it includes inflammation and it includes epigenetic changes so those are kind of the four buckets of the human stress response cortisol adrenaline inflammation and epigenetic changes and researchers actually manipulated mitochondrial genes two genes in the cell nucleus that control for mitochondrial proteins and two genes in mitochondria themselves and by manipulating these four different genes one at a time in mice they could impact all of the four aspects of the stress response and so what that means is that mitochondria are somehow involved in regulating the human stress response and so the way that I think about it is that and the way that many researchers actually think about it now is that mitochondria you know there are hundreds sometimes thousands of them in our cells in each of our cells most neurons have thousands of mitochondria the mitochondria are actually moving around they use the cytoskeleton to move around the cell they fuse with each other they it's called mitochondrial Dynamics they like change shape they do all sorts of things and again that impacts all of these signaling processes but that's just within one little cell so you can think of one cell is like almost a village of mitochondria that they're all just doing different things things and working together to help that cell function but in fact when you think about hormones like cortisol you can think about it as a way for mitochondria in one cell to produce cortisol that they can get sent to mitochondria in another cell to to make that other cell do something to either increase its activity or decrease its activity some people actually think about human cells as just a network of mitoch all kind of the mitochondria throughout the body and brain are just doing all sorts of things and at the end of the day we come back to just common sense at the end of the day it's about helping the organism adapt and survive ultimately organisms rule number one they need to survive rule number two they need to reproduce and rule number three they need to adapt and mitochondria are playing a foundational role in all of those basic aspects of organismal survival and again to some people that well that's so high level that's like well you're saying it's everything I'm like yeah it kind of is and mental health falls under it how could we think about mental health without thinking about the big picture like let's start with the big picture and then let's put Health into it and let's put the lack of adaptation or the lack of survival or the um these other things I'd like to take a quick break and thank our sponsor ag1 ag1 is an all-in-one vitamin mineral probiotic drink with adaptogens I've been taking ag1 daily since 2012 so I'm delighted that they're sponsoring this podcast the reason I started taking ag1 and the reason I still take ag1 is because it is the highest quality and most 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brought To Us by eight sleep eight sleep Mak smart mattress covers with cooling Heating and sleep tracking capacity now I've spoken before on this podcast about the critical need for us to get adequate amounts of quality sleep each and every night now one of the best ways to ensure a great night's sleep is to ensure that the temperature of your sleeping environment is correct and that's because in order to fall and stay deeply asleep your body temperature actually has to drop about 1 to 3° and in order to wake up feeling refreshed and energized your body temperature actually has to increase by about 1 to 3° eight sleep automatically regul regulates the temperature of your bed throughout the night according to your unique needs now I find that extremely useful because I like to make the bed really cool at the beginning of the night even colder in the middle of the night and warm as I wake up that's what gives me the most slow wave sleep and rapid eye movement sleep and I know that because eight sleep has a great sleep tracker that tells me how well I've slept and the types of sleep that I'm getting throughout the night I've been sleeping on an eights Sleep mattress cover for 4 years now and it has completely transformed and improved the quality of my sleep their latest model the Pod 4 ultra also has snoring detection that will automatically lift your head a few degrees in order to improve your air flow and stop you from snoring if you decide to try eight sleep you have 30 days to try it at home and you can return it if you don't like it no questions asked but I'm sure that you'll love it go to 8sleep.com huberman to save up to $350 off your pod 4 ultra eight sleep ships to many countries worldwide including Mexico and the UAE again that's 8sleep.com huberman to save up to $350 off your pod 4 ultra what are some of the things that we know can improve mitochondrial health either number function or otherwise and maybe we can talk about the basics first and get a little bit granular if you could about you know what are the prescriptions for keeping your mitochondrial healthy or improving your mitochondrial number and improving their function and then uh we can transition from there to the more let's just say um uh the more advanced ways of doing doing that um is there a role for supplementation is there a role for drugs is there uh you know these days well I hear about urethan a I um because I'm a little bit of an adventure these days I um and I'm turning 50 later this year I decide to experiment with a peptide that is uh sr31 which is specifically to improve mitochondrial function I'm doing this with the full understanding it may do nothing or it may kill me I don't know but we'll find out but um someone had to do it and and I'm a one variable at a time kind of guy um so it was important for me to stay with my current regimen and only change that do blood work etc because a lot of people some people out there are more um in the mode of trying to do a bunch of things and and I don't think that's as helpful to me it's also just not not it's not in keeping with my S scientist one scientist that is great that's right I'm monogamous with respect to variables right so what can we do at a basic level to keep and improve our mitochondrial number and function and if we have to hit on some of the usual suspects fine but if you could tell us how how we can do this so I'm really going to start with the basics and they're going to sound cliche and they're going to sound too basic to most people and I just want to set the stage for even for severe mental illness we can talk about strategies that will work and these strategies that I'm going to describe are not really appropriate like when when somebody becomes severely ill these strategies May may not be sufficient but the basics are what we call the field of Lifestyle medicine so there are six pillars of Lifestyle medicine they include diet nutrition exercise or movement sleep managing substance use ideally reducing it or minimizing it or eliminating it stress reduction practices mindfulness meditation yoga and the last one is relationships I throw in the word purpose into relationships because I think even if you don't have a lot of friends or family you can still have a very full thriving life if you have a purpose so those are the six pillars unfortunately this is where the cliches and the worthless advice begin especially in the diet nutrition camp because people will say eat more plants eat some broccoli have some good blueberries blueberries have antioxidants have some blueberries on whatever else you're eating and everything will be fine if you just add a couple of servings of blueberries a week you'll improve your health brain food and that it is such worthless advice it is not at all that simple and so so I think diet nutrition gets complicated fast the other things are actually pretty straightforward should you move your body yes should you stress your body intermittently allowing for full recovery yes that's what most people call exercise and what are you doing when you exercise you're actually if we look at like the muscles for example muscle tissue what exactly does exercise do whether it's isometric exercise to increase the size of the muscle or whether it's endurance capacity which actually does not change the size of the muscle at all um but allows for somebody to run longer faster harder so marathon runners for example can be quite thin you can look at a marathon runner and think you're not even an athlete they don't look all that different yet they can run sometimes 100 miles and what makes their muscles different than my muscles cuz I can't run 100 miles me either what makes their muscles different than mine even if the size isn't different there is one and only one thing that makes their muscles different and it's called mitochondria the number the number of mitochondria and and almost certainly the health of mitochondria you can actually take a biopsy of their muscle and you will see a much higher density of mitochondria in their muscle tissue than you will in mine if you actually then did a a a more thorough assessment of ATP capacity they their muscles or their mitochondria would be much healthier than mine they their mitochondria would have greater capacity for ATP production than my mitochondria would um so that's exercise there are lots of things you can do with exercise for people who don't exercise at all yes get out and just walk just do something maybe get some sunlight in morning while you're while you're at it um that sounds like a good idea uh the substance use um it's obvious it's the thing you've been talking about it I've been talking about substances deplete mitochondria I've been very interested in this um I'm a big lover of certain genres of music and um whenever topic of music comes up the name Rick Rubin comes up because he's been on this podcast twice the the famous Rick Rubin amazing producer and I'm blessed to have as a close friend and I often ask Rick I'm like why are so many of these folks in the in music dead there seems to be a history of people who did um stimulants it took a lot of stimulants cocaine and amphetamine in particular um musicians that did that in the 70s and 80s and 90s seemed to drop dead of heart attacks later when they were not currently using as far as we know those stimulants is it is it the case that stimulants like cocaine and amphetamine deplete cells of mitochondria do we do we know that to be true we do know and it's slightly more complex story so it's all about the dose um so stimulants are used to treat ADHD and we know that people we've known for decades people who have ADHD who have symptoms of ADHD have glucose hypom metabolism in their brains so their brains are not producing enough ATP from glucose what is one way to increase that dopamine dopamine will increase that so you can give people stimulants to improve their brain metabolism enough so that they now no longer have symptoms or at least have a reduction in their symptoms that story is unequivocally true we have lots of animal data human neuroimaging data clinical research studies documenting that appropriate doses of stimulants so that's usually loish doses can improve brain metabolism and what that means is that it's they're actually stimulating mitochondria to produce more ATP however metabolism is all about balance you can underdo it and you can overdo it and when you overdo it what happens is that if you hypers stimulate mitochondria with high doses of stimulants the mitochondria are essentially running on all cylinders and electrons start leaking out of the electron transport chain and what happens is that that creates reactive oxygen species which then damage the mitochondria themselves and damage other aspects of the cell and it can lead to Chronic mitochondrial disfunction chronic metabolic dysfunction it's challenging with stimulants because people are looking for a yes or no answer so Dr Palmer do you think stimulant are good or bad I don't have an answer to that it depends on the person it depends on the dose of stimulants it depends on the type of stimulant it depends on what impact it's having on that person um but we need to open our minds to the possibility that yes maybe some people do benefit from stimulants and maybe at the same time other people are harmed in catastrophic Ways by stimulants um and it it can all be linked through mitochondrial mechanisms it can certainly be linked through dopamine but again we have to ask well what is that dopamine doing to to the target cells that when dopamine gets released and connects with the dopamine receptor what happens to that Target cell it changes the metabolism of that Target cell it increases the activity of that Target cell so stimulants are one back to this bigger kind of Lifestyle medicine picture stimulants are definitely one hyos stimulants very harmful to human health what are some others alcohol we've known since the 1960s in the 1960s researchers were trying to figure out how the hell does alcohol cause therosis we knew that we've known that we've known that for a long time alcoholics develop liver failure they develop therosis of the liver and they can die from it how exactly does that happen in the 1960s researchers figured out it's mitochondial tox toxicity interesting in the liver cells that is what's making the liver cells die that alcohol gets converted into this molecule called acid alahh which is very toxic to lots of cell parts but in particular to mitochondria mitochondria are processing this Alcohol and Other enzymes and kind of other things are trying to detoxify the alcohol but at the end of the day mitochondrial toxicity seems to be a clear route so when you know when I was doing research on mitochondria for the book it I there was an over there were over 10,000 published research articles of alcohol and mitochondria and I was initially shocked by that and I wondered like what's that about like how that's that's how I know this 1960s story and everything else is because researchers been looking at how how is it that alcohol can be so toxic and the two organs that are most effective are the liver because that's the primary organ trying to detoxify it and then the brain and why the brain because the brain is highly sensitive to metabolic disruption other substances of abuse tobacco the carcinogens in tobacco so not nicotine per se do we know if nicotine is depleting mitochondria nicotine is a stimulant for mitochondria so again similar story low doses can be great high doses May in fact be toxic oh good you've got to get you gotta you got to find the right balance not a big nicotine guy but lately I've started uh chewing half of a piece of nicotine gum a few times a week um so 2 milligrams to four milligrams which is very low dose um couple couple of I would say maybe three four days a week I'll do that and um I'm doing it specifically for brain health reasons and I have no relationship to any nicotine pouch or gum or anything like that so I want to be really like company um so I'm doing a little experiment and uh you know it's it's interesting stimulant because it relaxes you a little bit too but I wouldn't want kids to start doing this or people in their 20s or 30s like I said I'm approaching the fifth floor I'm going to be 50 in September and um I want to do everything I can to hold on the neurons I've got so I think low-level stimulation of perhaps the mitochondria and other um certainly the stoline system with nicotine it's a good idea but what I see is a lot of people who are taking these pouches that range from anywhere from 3 milligrams On The Low End uh Dose side all the way up to eight milligrams and it is very habit forming people start with one pouch or two pouches a day and pretty soon they're doing a canister every day or two so even the cost starts to be a big deal but it's it's pretty incredible was on the Berkeley campus and I went to a little convenience store near the Berkeley campus recently this kid came in and we started chatting a podcast fan we were chatting and he was there to buy uh nicotine pouches I said how many of those do you go through a week he's like seven or eight I was like really was engineering student but in my years in college it was always just you know some coffee or something yeah some coffee we didn't really have stick with coffee for the young for Young Folks yeah for the young little a little bit of coffee it's about it's about dose and it's about look so most things that enhance metabolism quickly can be addictive and I think that's the challenge for a lot of people is that you get that energy right away at some point you acclimate to that substance somewhat and then you want more you want that same increase that you got before um so it's just important to kind of be mindful that you can overstimulate metabolism mitochondrial function and then you start depleting mitochondria and and and then yeah and then you actually the mitochondria begin producing more more reactive oxygen species which ends up being detrimental so it's like driving your car again if you think about mitochondria like an engine it's like an engine of the of your car when you're driving your car on the highway you don't want to go too slow and you don't want to go too fast acceleration is costly and acceleration is costly right I mean that transmission systems you know create this incredible efficiency of being able to travel at speed uh with more efficiency you know but accelerating is is is is a different thing altogether I mean that's the way that I think about it and so somebody who's addicted to drugs and alcohol for example they're on a roller coaster ride of hyper stimulating their metabolic rate and then trying to suppress that hypers stimulation with sedatives so that they can sleep or calm down and then they're just but they're destroying their metabolic health and does that really play out like and is that you know some will say well Chris that's just one of myriad things that they're doing to their cells sure but does it play out in diseases that we think of as metabolic diseases absolutely type two diabetes yes cardiovascular disease 100% like premature mortality yeah um like it there's it's kind of like the elephant in the room that we have just failed to look at because we've been so splintered with no it's biological no it's psychological no it's social it's like it's all of them let's look at the elephant that comprises all of them one of the beautiful things about science is that you isolate variables you can get very reductionist we know that there are these things called mitochondria that they move around I mean these discoveries are are truly incredible that have been made in the last 100 years or so but there's been this um kind of obsession I I think in in the the public discussion around Health that you know around things that are obviously related to the thing that you're trying to cure so serotonin and brain health it's like oh okay makes sense you know the listening to proac what came out you increase serotonin some people are feeling better maybe it's through neuroplasticity maybe it's through effects of Serotonin and but it makes sense serotonin brain right you know it um but if we zoom out from that and we accept because it's true that essentially all cells are dependent on mitochondria for their function why wouldn't we go to this fundamental layer uh first in order to try and improve mental and physical health simultaneously right it's a very different way of approaching medicine in general normally we go okay well the issue is right here that's where the tumor is that's where the circuit deficit is this is where the the lesion is or the growth and we're going to go there right but um to avoid that the pathologic state in the first place uh these six pillars are wonderful by the way a diet exercise sleep substance overuse or abuse stress mitigation and relationship SLP purpose um so we're going to keep returning to this theme of of mitochondria's foundational um throughout today's discussion because I think people need to to frame their health in that context I I really do also um years ago my postto adviser the late Ben Baris he died unfortunately pancreatic cancer but just seeing incredible scientist um MD and uh scientist who really popularized the the study of glea prior to that they were seeing this kind of like backw science no one everyone thought it was just glue for the brain he used to uh stop us in the hallways late at night and he used to we called it getting bend because you'd want to leave and he would like he was a night owl it was awful and you get stuck there but I'll never forget he stopped me he called me Andy and he said he did this numerous times but he said Andy why no one calls me that by the way anymore um he said Andy why is it that as we get older we have less energy and I'm like I don't know Ben he's like someone needs to he's like why don't you work on that why are you working on these retinal cells like you you should work on that and he said why is it that we that our brain is less plastic like well I don't know I think it's the Gia right and there is some evidence that it has something to do with the Gia um among other things but there's a fundamentally interesting question you look at kids and they're just full of energy and we there's the NAD hypothesis and there's these other but it always seems to Circle back to mitochondria yes over and over so I think the answer is very clear it's it's we have a ton of mitochondria early in life and over time it gets depleted is it that simple I mean there are other things too there are other things but I I actually do think that's a it's not just the the number and density of mitochondria but it's the health of mitochondria because unfortunately you know our cells have a process for getting rid of defective mitochondria um it's part of autophagy there's a sub kind of category called mitophagy in which defective mitochondria should be shuttled to lomes or shuttled out of cells recent paper actually found that microa in the brain again send out these nanot tunnels to asites and collect defective mitochondria from the neuron amazing and then take care of the disposal process for that neuron we are so cool and that when you inhibit that it appears to increase and accelerate neurod degeneration and when you enhance that it appears to improve um or reduce neurod degeneration but I think it is I think children have more energy because they have healthier metabolism healthier mitochondrial function and when we look at like again like is there evidence for that there's overwhelming evidence for that there are thousands of peer-reviewed published articles in leading journals nature cell all sorts of journals over the last several decades just to again try to bring this back to just common sense so we have these things called diseases of Aging what are are the diseases of Aging the diseases of Aging are obesity type 2 diabetes cardiovascular disease cancer neurodegenerative disorders those are universally thought of as diseases of Aging interestingly what often gets left off of that category are the mental disorders especially today a lot of people think mental disorders as primarily a youth problem but in fact mental disorders depression anxiety psychosis are actually diseases of Aging so the Center for Disease Control has put out kind of charts of any age group we what is the probability if you are you know a youth in America today that you will be prescribed an anti-depressant an SSRI anti-depressant if you're between 20 and 40 what's the probability among the remaining people who are still 20 to 40 among all the people that age as people get older the risk for anti-depressant prescription goes up the highest Cate category of people prescribed anti-depressants are 65 and older really well I guess uh some sound that make sense although I would have thought it would be the younger population most people do and that's why I'm saying this because it's shocking to most people it was actually surprising to me but I'm I was thinking wait if my theory is correct then mental disorder should be a disease of aging and in fact they are antis psychotic prescriptions what age group is the most like to be prescribed an Antico over AG 80 really oh it goes through the roof because dementia is associated with 40 to 50% of the people with dementia will have psychotic symptoms hallucinations and delusions um they'll have agitation the benzo diazines the prescription rate goes up now with them with benzos there there is a dip start at age 65 and that is really because Physicians are explicitly told do not prescribe benzos to people over 65 so the rate starts going down but with anti-depressants it's almost linear the older you are the more likely you are to be receiving a prescription for an anti-depressant anticho discs there are some waves and shifts women for example around the time of menopause get a peak so you get a peak around the age of 20 which is new onset schizophrenia and then it kind of comes down a little and then women round time menopause higher Peak and then it kind of comes down a little and then lateen life goes through the roof goes through the roof again because of what we call dementia so the diseases of Aging anyway are all of the metabolic disorders and oh by the way the mental disorders and in my mind we need to tie that together that is not a serotonin problem right we need to tie that science together and the only way to tie that science together is to look at the bigger picture that we call metabolism and ultimately you have to look at mitochondria and mitochondrial biology to understand it I'd like to take a quick break and acknowledge one of our sponsors function last year I became a function member after searching for the most comprehensive approach to lab testing function provides over 100 Advanced lab tests that give you a key snapshot of your entire bodily Health this snapshot offers you with insights on your heart health Hormone Health immune functioning nutrient levels and much more they've also recently added tests for toxins such as BPA exposure from harmful Plastics and tests for P fases or forever chemicals function not only provides testing of over a 100 biomarkers key to your physical and mental health but it also analyzes these results and provides insights from Top Doctors who are expert in the relevant areas for example in one of my first tests with function I learned that I had elevated levels of mercury in my blood function not only helped me detect that but offered insights into how best to reduce my mercury levels which included limiting my tuna consumption I've been eating a lot of tuna while also making an effort to eat more leafy greens and supplementing with Knack and acetylcysteine both of which can support glutathione production and detoxification and I should say by taking a second function test that approach works comprehensive blood testing is vitally important there's so many things related to your mental and physical health that can only be detected in a blood test the problem is blood testing has always been very expensive and complicated in contrast I've been super impressed by function Simplicity and at the level of cost it is very affordable as a consequence I decided to join their scientific Advisory Board and I'm thrilled that they're sponsoring the podcast if you'd like to try function you can go to function health.com huberman function currently has a weight list of over 50,000 people but they're offering Early Access to huberman podcast listeners again that's function health.com huberman to get early access to function let's talk about diet and nutrition for a moment um in recent years you've talked a lot about the clinical use of the ketogenic diet for various mental health disorders and cited some spectacular results um and this has had a huge impact on everybody's thinking about what ketogenic diets originally were for it was developed as a medical treatment for epilepsy is my understanding only later did it become uh popular as a potential Avenue for losing body fat Etc but what are some of the ways that people can use diet and nutrition to improve metabolic Health generally but let's be more specific mitochondrial Health number turnover all the good stuff that happens in mitochondria um how can nutrition be used um to improve that and why would it be that the ketogenic diet would improve mitochondrial function or is it that the ketogenic diet bypasses the need for standard cellular metabolism by um pulling on some other cellular metab metabolism um uh mechanisms I'm I'm just trying to draw the link here between uh ketogenic diet and mitochondria because we've you've well established that mitochondria are Central to this whole picture of mental and physical health I'll throw in a plug before before I go deep into the um ketogenic diet story but you you also threw a question in there about other dietary interventions or how can diet impact there is no question diet plays a profound profound and Central role to human metabolism and all of the consequences of human metabolism and you very eloquently laid out the case for early life a woman who's breastfeeding her infant that breast milk has a profound impact on whether that baby's brain develops normally or not that has dire consequences potentially for the outcome in the health of that child and it's all about nutrition we've known that for decades that if women are malnourished during pregnancy it impacts that infant the the the fetus's lifespan really it increases risk for mental disorders and metabolic disorders increases risk if if your mother is starving while she's pregnant or has to fast or has to go without nutrients it increases that child's risk for metabolic disorders obesity diabetes cardiovascular disease um we've known that and that is um you know there are lots of theories about obesity around that it also surprisingly increases risk for schizophrenia and bipolar disorder and antisocial personality disorder and all sorts of other mental disorders in terms of other dietary patterns I I just want to and we can do a deep dive into any of these you want and then I'll go on to ketogenic diets but Ultra processed foods really bad for your physical health and your mental health we have just growing body of evidence for that is that because of The increased calorie consumption there's this really nice paper that was published a few years ago showing that people who um eat above a certain threshold of processed foods tend to consume on average about 500 calories more than they require per day which might not seem like much um but over time that compounds and they gain a lot of adapost tissue and and then the adapost tissue is secreting a lot of things into the bloodstream that make the whole situation even worse both brain and bodily um but aside from the caloric load I mean is there any evidence that these food dyes and other things that are included in these foods are are detrimental to mitochondrial Health this is a somewhat controversial thing these days because some of these dies were banned recently which I saw as a good thing but then some of the die hards in the scientific Community like oh those dosages are represent like 6,000 fold what you'd have to what most people eat you know the dosages used in mice but but the FDA still pulled the dies and the FDA is a pretty conservative body um so I don't know it I not every chemical is bad of course um but are these additives really that bad so to try to answer your question are the chemicals and additives harmful the real answer is we don't actually have adequate scientific evidence one way or another and why don't we have adequate scientific evidence because we're not spending money to research it so right now the the rules to this day are that um you know there's this concept called grass General regarded as safe that food companies can develop new molecules that will preserve a food make a food hyper palatable make it tastier make it more shelf stable whatever whatever they want to claim it does that they can develop molecules they can put these molecules into our food and they can get away with just saying well this is just general regarded as safe without any adequate safety testing whatsoever and the FDA allows that now the new new Administration RFK Jr just ly said he's going to try to change that rule and I welcome that change I think that will be a phenomenal change but the re so the reality is that testing hasn't been done on all of these molecules there are tens of thousands of molecules and like new chemicals new additives things that sometimes aren't even on the label that are added to food and we really don't know for sure for each and every one of them whether this one is safe or not safe what we do know overall and this unfortunately comes down to epidemiological studies where they just look at hundreds of thousands if not millions of people and they assess like how much Ultra processed food is this person eating and is that Associated if we look at large populations of people and we stratify them by the these these people are eating Mo mostly Ultra processed foods and these people are hardly eating any are there differences in their health outcomes and the answer to that is unequivocal and it is perfectly clear the more Ultra processed foods you eat the worse your physical and mental health both its cardiovascular disease its obesity its diabetes its mortality it's cancer it's also a broad range of mental disorders and so we know that we we've got more granular data that's hyper focuses on the mental health story you know one study over 300,000 people the more Ultra processed foods you eat a direct linear relationship it was shocking how linear it was the more Ultra processed foods you eat the worse your mental health and it was so striking it was not a subtle difference it wasn't like you know oh it was a 3% difference between the lowest it was a threefold difference wow the people who consumed Ultra processed foods every day multiple times a day 58% of them had poor mental health compared to only 18% of the people who rarely or never consumed Ultra processed foods wow so this would be even just like somebody has like a bag of chips and some um you know just pour in water type pre-made soup or something like that uh those are ultr processed um this would be somebody orders a sandwich at the deli for lunch which can be done in a relatively healthy way depending on what's in that sandwich um and then does soda and bag of chips on the side like I mean you're that's a lot of in my opinion highly processed food but people I think sometimes people don't think of it that way yes one of I was um surprised and somewhat delighted to learn that one of the ways that um the you know the public health uh folks uh got kids to smoke fewer cigarettes because when I was growing up like smoking was cool like you smoke cigarette it was cool people thought it was cool definitely is reinforcing because of the nicotine the dopamine increases um and it was considered cool um you had your like maror man image from the preceding decades but then it was really the the uh the 9s kind of um it was the actors and models and stuff that made it cool like people smoked and it was supposed to be cool and one of the ways that um we ended up with people smoking far less was not just to ban it on campuses because that just makes teens want to do it more right in college you want to do it more um was to have these commercials of these um it was all to be direct it was just like these um rich white guys in a room that was portraying like the boardroom of a tobacco company and they were like cackling and talking about like haahha they think we're going to they don't think it causes cancer and this kind of thing basically pitting youth against adults so that the youth felt like their money was being taken by the by The Establishment so is there a world where you know kids are going to be like like you know forgive me but you know like f that I'm not eating Doritos you know like I'm not going to be manipulated by highly processed foods or I'm going to hold on to my mental health by making healthy choices in terms of food It's Tricky but it has a lot of the same parallels to cigarette use or alcohol use but I feel like the only way to really get Americans to change their behavior besides scaring them fundamentally but even if you do that is to incentivize it and one of the best incentives historically for public health change has been to pit the make the public feel like they're pitted against the people that are trying to take their money unfairly and make them unhealthy at the same time you got to activate that kind of rebellious Spirit uh-uh not going to do it just telling people is bad for you doesn't work right we know that how do we incentivize people yeah I'm not going to give a cliche answer because this is the trillion dollar question that everybody's asking and and it it really you know the the health of our country really kind of depends on it with billions of dollars that this industry has in Revenue annually they can spend a lot of that money on really impactful marketing campaigns getting people to believe that it's not it's not as unhealthy as Chris Palmer and Andrew huberman are saying it's fine everybody deserves a treat within the last couple of weeks the American Heart Association was actively lobbying against a Texas bill that was trying to restrict spending food stamp money on junk food I saw that clip it's so disturbing to see someone from the American Heart Association actively lobbying to keep tax dollars directed towards including sugary soda not even diet soda but sugary soda in uh lunches and and food for people who are uh low income and he went on record as [Music] saying this junk food this Ultra processed food is not the root cause of obesity or diabetes or any of these health conditions which is an absolute abject lie and when you have supposedly respected organizations being bought by industry promoting misinformation I it's really hard you know everybody's all upset that like oh people don't trust the science they're not respecting the respected organizations well the respected organizations need to step up and start behaving in a respectable manner they need to stop the American Heart Association should not be taking a dime from any industry that plays a role in heart disease like they it would be like it would be like the American Heart Association taking money from tobacco companies and then coming out and say smoking doesn't really cause heart disease people everybody calm down there there there's still a lot that we don't know we need more research we need more research smoking doesn't cause heart disease people this is just scare mongering this is just paranoid conspiracy theories that is exactly what's happening now they're taking money from food companies that have no vested interest in the human in the health of the population that they are feeding they know perfectly well that these foods are highly palatable um and what does that mean it means addictive and again if I was selling food I would want people to be addicted to the food I was selling why because you sell more higher margins if you sell food that people aren't addicted to they'll just move on to the other food that is addictive and and then you'll be out of business so it's not an easy problem to solve I don't mean to imply it's easy because if if one or two companies steps up and does the right thing they'll just go out of business well I feel like the the smoking parallel is is critical and maybe the trans fat um the history of of entire cities Banning the use of trans fats for instance or the use of a styrofoam containers right it's very different very different issue it doesn't directly get to human health of the styrofoams not good but it's about it's about waste and and um environment but I feel like there has to be a top- down ban and Americans also don't like bans right we don't we don't like things we like choice but we don't like the consequences of those of choice and then we want people to fix the consequences of those choices um with treatments that don't have side effects and then this is like kind of the cycle that that I've observed in my lifetime over and over again you know I think it's the Rebellion piece it's when people realize they're being manipulated once people realize they're being manipulated I feel like that's when they're willing to intervene uh and stop otherwise reinforcing activity reinforced addictive activity save money and like take a different direction like that's that's inherent to the American Spirit as much as we love freedom we also we have this like no you're not going to you're not going to do this to me kind of Spirit we see it everywhere this is my belief but then again I was kind of a rebellious team but but if it's in service to health I'm I'm hopeful I mean my my understanding by no means am I an expert but my understanding of what really drove the reduction and tobacco use was the taxes and the ban on Advertising the ban on television advertisements interesting that that when you get rid of the advertisements you're no longer tempting people with it um you're no longer able to spread misinformation um and when you make the product so expensive people just even if they want to try it even if they're already addicted to try already addicted to it now they are highly motivated to get off of it why because it's costing them an arm and a leg Yeah money hurts and and they and they realize that I I just don't want this we could do similar things with ultra processed foods if Rebellion education whatever I I don't care what works but all of the above we're we're we're really fighting an uphill battle so Ultra process food that's just one story vitamin nutrient deficiencies do you want to go to ketogenic diet you asked me about that and I got sidetracked yeah we went into a public health discourse we're weaving back and forth that's what we do here I think it's I look it's very timely right I don't care if you're the staunchest Democrat or the staunchest Republican or somewhere in between like these issues affect everybody and um anyone who just wants to view Maha as a republican thing it's fine that I'm I'm not affiliated with Maha I I am in favor of improved Public Health from whatever angles that can meaningfully be done um so tell us about ketogenic diet and then I'd like to ask about things that we can do to improve mitochondrial function in these other bins but does ketogenic diet improve mitochondrial function and if so H how does that work The quick summary story for people who don't know ketogenic so ketogenic diet is a 100-year-old evidence-based treatment for epilepsy it can stop seizures even when medications fail to we have um over a dozen controlled Trials of ketogenic diets in children in particular with treatment resistant epilepsy we have two Cochran reviews that came out positive so Cochran reviews are the gold standard in the medical field for metaanalyses um very rigorous and they analyzed the data that exists and came to the conclusion that ketogenic diet if somebody has treatment resistant epilepsy compared to treatment as usual which is try another anti-epileptic medication the ketogenic diet is six times more likely to result in seizure Freedom wow than just trying yet another epilepsy pill so the ketogenic diet is a powerful anti-convulsant treatment we use anti-convulsant treatments in Psychiatry every day in tens of millions of people lots of these medications are used so um so at this point we now have over 50 published pilot trials case series case reports other lines of evidence of the ketogenic diet for psychiatric disorders um schizophrenia bipolar disorder depression anxiety anorexia or neosa surprisingly um these 50 reports represent over 1,900 people and on balance the ketogenic diet appears to be an effective treatment sometimes an extraordinarily effective treatment like in able to induce remission of schizophrenia or bipolar um in people who otherwise had treatment resistant disorders and they're going off medication simultaneously some of them are um so there are you know I have heard probably from thousands of people around the world since my work has become more public and actually our first podcast together hands down the most cited reason people know who I am as they should well I know about you but it's huberman hu that huberman Lab podcast I'm just I'm just a a a uh a runway for people to uh incredible messages to take off thank you again for the opportunity to disseminate this word and because at the end of the day I'm hearing from thousands of people who simply listened to that podcast made changes started a ketogenic diet for their schizophrenia or other treatment resistant mental disorder reach out to me you saved my life I can't tell you how many times I've gotten handwritten notes emails messages from people who use those words you saved my life I never met this person all I did was share this knowledge and then they saved their own lives with knowledge coming back to your question now in a roundabout way does ketogenic diet impact mitochondrial Health we we have strong evidence that it does and um so it appears so the ketogenic diet is mimicking the fasting State and I just want to say that again the ketogenic diet mimics the fasting State what does that mean it means the ketogenic diet is mimicking no food consumption so is the ketogenic diet the healthiest diet that everybody should follow no that's not the way I think about it the ketogenic diet is an intervention it is Shifting metabolism it is Shifting countless kind of systems signaling Pathways other things gene expression in the human body and brain and that results in effect facts and the good news is these effects appear to be lifechanging and life-saving sometime so they're highly beneficial effects um again dose and the way you do it matter because fasting the the extreme version of fasting is starvation and that results in death so that is not at all a good thing so let's make sure that if you're going to do a ketogenic diet or a fasting regimen that you're not depriving yourself of essential nutrition that um you're getting enough calories you're getting enough nutrients that you're doing it in a a medically sound way so that you're optimizing your health and not hurting your health um but we have you know it's it's hard to measure this in humans in v in vitro because we can't like do an intervention to a human and then dissect their brain and like biopsy it and look at the mitochondria under the microscope so we mostly have animal data that supports this but animal data strongly supports that ketogenic interventions improve mitophagy so getting rid of these old and defective mitochondria so you're kind of cleaning house you're getting rid of the bad and then you're replacing them with new fresh ones mitochondrial biogenesis so that at the end of the day the cell will have more healthy mitochondria now some researchers have really hyperfocused on the ketogenic diet might be working through the gut microbiome this gut brain connection and we have some evidence that that is true so researchers actually took feces from human children with epilepsy before starting a ketogenic diet and then afterward while they were stable on a ketogenic diet and then they transferred these FAL samples to mice who were predisposed to epilepsy or predisposed to seizures when they took the feces from the children while the children still had were seizing the mice were more likely to seize when they took the feces from the children doing the ketogenic diet and transferred it to the mice the mice were less likely to have seizures interesting even though the mice were not on ketogenic diets so there's something in the feces of children with epilepsy doing ketogenic diets that result that has an anti-seizure effect what could that something be it could be the gut microbiome but it could be molecules neurotransmitters neuropep other things that those microbes are producing or it could be neuropeptides and other factors that the gut cells are producing so we really don't know for sure what exactly is it so on the surface there's something in the feces there's a gut microbiome a gut brain connection thing what does that have to do with mitochondria so another research group did that same model got mice to have an anti-seizure effect from a ketogenic diet and then dissected their brains looking for what changed in the brain how exactly is a ketogenic diet having an anti-seizure effect in the brain because it that's the pathology the pathological finding seizure is occurring in the brain and when they analyze genetic changes up regulation down regulation it all centered on mitochondria that the changes in the gut were resulting in mitochondrial changes in the brain which means brain energy metabolism in the brain and um so again it's an umbrella Theory doesn't replace what we know it's not gut microbiome or s serotonin it's not gut microbiome or mitochondria it's both both of them are true and it's all interconnected um so I I do think we've got more than enough data that ketogenic therapies impact brain metabolism which then impacts neurotransmitters a really what I hope will become one of many really important Stu studies um published by Ian Campbell and colleagues in the UK that uh they just did a pilot trial 20 patients with bipolar disorder put on ketogenic diets and they found in wide- ranging improvements in metabolic Health biomarkers like weight blood pressure other things but they also found a reduction in brain um glutamate activity which is often associ iated with bipolar disorder and Hyper excitability and seizures um and so that helps us understand again it's not it's not metabolic or glutamate a neurotransmitter it's both it it it it's putting it together yeah the Campbell study is really interesting we we'll link to that in the show note captions and incidentally we will also link to this um American Heart Association appalling uh quote unquote testimony sorry AJ I'm not I'm not sorry I'm not uh not sorry um but then again I'm not a physician so I don't have to worry about that well maybe I do anyway I'm not a cardiologist is there any uh rationale for people who don't have epilepsy or don't suffer from bipolar schizophrenia um but like myself would like to keep our mitochondrial function as as strong as possible and for doing a brief ketogenic intervention yes the answer is yes can intermittent and I'm so I'm going to lump ketogenic with other fasting mimicking diets and fasting itself so can intermittent fasting or can cycles of fasting have health improving qualities or health improving effects absolutely so interestingly before I talk about even some of the science on this and there it's not super robust why because again we don't fund diet studies there's no money to be made from dietary interventions really there's no patent on it nobody cares about dietary interventions but there are a lot of studies on exercise interventions but even those are they're not huge randomized controlled trials with 10,000 participants they're not you know like even the federal government will fund large scale medication trials Statin studies and others but they often don't I mean there have been a few the Women's Health Initiative funded a massive dietary intervention study and unfortunately that was a huge disappointment to the field because it was negative they randomized women to just keep doing the diet you're eating or go on a lowfat diet and the lowfat diet didn't do anything for their heart health or other objective kind of outcome measures and put another way just to just to really close this for people it means a lowfat diet is no better than the standard American diet a lowfat diet is equivalent you get equivalent health effects from a lowfat diet to a standard American diet that's really bad so lowfat diets need to go away and people who promote lowfat diets need to stop promoting they need to get come up to speed with the science and just like move on like at least acknowledge there are healthy fats even though fat has more calories don't worry about those calories worry about the health effects the long-term health effects yeah you got to get those monounsaturated fats and you got to eat your Omega-3s and you have to you know and I'm a Believer in eating some butter here and there you were asking me about intermittent ketogenic or inter intermittent fasting so I'll just say that we have a long history in multiple cultures on Earth for thousands of years fasting has been part of healing rituals um India China Christian like fasting has been a part of rituals and you know most people just assume it's religious folklore or just silliness or whatever but I actually think Millennia of humans we're not all stupid idiots and that some people along the way actually noticed this seems to do something useful and that's probably why it found its way in every culture and persisted for thousands of years because there was actually something meaningful happening so what we have now in terms of more controlled trials I'm going to site wter Longo who um he doesn't call his diet a ketogenic diet although it is a ketogenic diet he calls his diet a fasting mimicking diet and it's primarily a plant-based 600 calorie a day diet some people are going to hear that and just gas it's it is proprietary to him I have no relationship with him I'm not promoting his product but he has a proprietary product called prolon you can get the benefits by just not eating anything or by eating 600 calories a day I mean you can you don't need to buy that proprietary product but because he is selling this product I believe he's using most or all of the funds that from the most are all of the proceeds from the sale of that to fund research on it they've done a series of studies that uh 5day Cycles several times a year seem to be fine and improve a wide range of Health biomarkers interesting and there's reason to believe that it may help improve metabolic Health and Longevity so he's primarily a longevity aging researcher he is promoting that could ketogenic diets also produce Sim effects I believe they can again it gets really controversial fast because ketogenic diets can sometimes include red meat and then we got the American Heart Association telling us that red meat's bad for you and don't eat that red meat nonsense and uh well that we so then we get these splintering groups and we've got the vegan groups saying that's awful for you and unfortunately it just leaves people confused about like what what are we supposed to do do we eat red meat do we not eat red meat do we like in moderation healthy sources I feel like but in moderation from healthy sources not the processed stuff but you know I I get it people have animal reasons or environmental reasons they don't do it um you know the debate goes on and on I've observed some people who are vegan who seem very healthy very robust um aesthetically they they present well if I'm just going to be direct about it and then I've seen some people who go vegan and and it's the exact opposite and then I've seen um I think the strict carnivore thing seems to work for very few people but the ones who love it really love it but even the folks like Paul saladino who were the so-called you know carnivore diet are now then it became animal- based and it now includes fruits and cucumbers and tomatoes and um some Dairy and you know and so hone you know and honey and um and I like Paul I get along well with Paul I also get along with Lane Norton and the they don't get along um but you know I I think it's it's to each their own within the context of um the correct number of calories for a given person and their activity levels but this idea of doing a per of periodically doing a perhaps a fast along the lines of the longo um uh prolong thing or um or or total fast or water fast I guess it's called or um perhaps intermittent fasting on a on a more um reasonable schedule are there any data on that like eating only between the hours of say 11:00 a.m. and 7:00 p.m. which is I which is what I happen to do reflexively unless I wake up very hungry which is really rare I don't know why maybe it's function of getting older but is there any evidence that intermittent fasting that doesn't involve entire day and night fasts but more of the you know Tim restricted feeding to eight hours or 6 hours that it can be beneficial for mitochondrial function if it's done for short bouts of two to four weeks my understanding of the literature is that it's a mixed bag when it comes to time restrict eating and intermittent fasting um because more often than not they don't control what people are eating when they're eating oh well that's no good so they just those studies mostly are designed to just say Don't eat only eat between 11:00 a.m. and 7 p.m. and eat whatever you want but it doesn't M like and as though it doesn't matter what they're eating and some people are binging on Ultra processed foods and others are eating like an adult and uh and then you've got everything in between as though that doesn't play a role and and so you get these studies to say it doesn't do anything useful you get other studies that say maybe it does something useful um so I think I mean at the end of the day I will say this you know I'm you know I've been talking a while with a a really seasoned established um EXP ERT in the nutritional space in the conservative nutritional space he's held several government positions he's helped presidents and um others with campaigns and he has made a very strong case to me that you know less than 5% of the research budget from the NIH is spent on nutritional research the NIH has an office called the office of nutritional research focused on or organizing collaborations among different NIH institutes and centers and their annual budget for a major government organization their annual budget is 1.3 million with an M dollars my goodness that's that's which is a joke it is a laugh joke can't do much with that and without trying to make this political there have been people who have tried to increase the funding for nutrition research recently was proposed to increase that funding to $13 million and it was cut that idea was killed by the lobbyists of the food companies I'm going to get really vocal about this lobbying through the American Heart Association thing because I was just shocked right for all the obvious reasons American Heart Association you assume that they are all about healthy hearts and we know metabolism is and um healthy weight and activity and all that is healthy for hearts and it it was so clear that they were on the take from these food companies and that's why they send even just the timing and the delivery again I'll post to the link because it's just like jaw-dropping like I can't believe this it's like it's like the old commercials of the people from the cigarette industry saying yeah the cigarettes don't cause cancer and you they know it does and and we're just this is happening now in real time and um this conversation will certainly assist in and drawing attention to this I'll probably do a social media post on it as well but there's this this thing that happens in medicine and public health where the thing that's so obviously the problem is like it's not even staring Us in the face it's like slapping Us in the face and we take 20 to 30 years relying largely on um messaging through Hollywood kind What actors are doing what athletes are doing then people are like oh yeah maybe this is a thing and then think the battleship just SL like eventually just pivots but there's been Decades of horrible Misfortune and loss in mental health and physical health people thinking that there's something wrong with them or you know um etc etc I mean it's it's it's asinine it's crazy and so I'm excited about Maha even though I don't have any affiliation to it because it it's it's the first time time in my lifetime that anyone said like hey let's actually just talk about and think about how to really get healthy what do we know right now and so I'm I'm not a political person but I think it's really important um that we get focused on what's literally slapping us right in the face with like this is absurd for forgive me for editorializing here but we keep coming back to this we know what what we need to do we know what we need to do but yeah we have not had the political will to do it I think the hope is that one hopefully of many good things that could come out of Maha is separating industry interests from the Health and Welfare of the American population I think if we can do that and we can begin doing unbiased research to really determine what is it about Ultra processed foods that results in harm we know they result in harm is it just that they're so delicious that people consume extra calories and it's still just as simple as calories or is it that there's something in those chemicals that makes the foods addictive or is it that there's something in those chemicals that actually impairs mitochondrial function I think we have evidence to support all three of those hypotheses do people consume extra calories yes you cited one of now many studies documenting that are they addictive yes unequivocally they are um I mean the most common eating disorder diagnosed today in the United States is called binge eating disorder what what are the criteria for binge eating disorder it's basically addiction to Ultra Foods is is really if you look at the criteria and if you look at the behaviors when people engage in binges they're not binging on steak and broccoli ever like never never are they binging on steak and broccoli they're binging almost exclusively on Ultra processed foods and then they go through these Cycles where they binge on them and then they beat themselves up and they feel disgusting and they're they're ashamed and they're humiliated and and then they try their they White Knuckle it to avoid those foods and then something bad happens in their life they get stressed somebody cuts them off in traffic they've had a hard day at work their boss came down on them whatever and and then they go home and they're like you know screw it I hate my life I hate myself I don't Health doesn't even matter for me addic cycle and I may as well just enjoy myself and just like an alcoholic would just like a cocaine addict would um it's not that people are using every single day you know they go through cycles and um it's really tragic Harvard Medical School just literally two days ago came out with an article is sugar addictive and their conclusion no no because sugar's found in fruit so it can't be addictive I'm like really is that and they they actually they went out of their way to say well you know like it's not like addictive like alcohol and nicotine because people sometimes have trouble stopping those completely and I'm thinking and what do you think is different about sugar unbelievable do you really don't understand that some people can't stop consuming Ultra processed high sugar foods you really don't understand that like are you living in an ivory Tower yes and I'm not but no I'm I'm certainly not not any longer and it's also I think important that the highly processed foods and the palatability and the accessibility and the low cost right we're not talking about eliminating pie and pastries I think sometimes people think oh like I'll never have a muffin again I'll never have a chocolate croissant that's not really what we're talking about we're not talking about a homemade cake we're not talking about cupcakes we're talking about things that are easily purchased at low cost unpackaged eaten in transit what we're doing I I realize is painting this picture of a little bit of the past the recent past but what you do so beautifully is you you're really orienting us where we are now and that the fact that we need more science but we we know an awful lot and there's so much that we can do and these six pillars of you know diet exercise sleep avoiding excessive substance abuse or use or abuse excuse me stress mitigation relationships and purpose um which Center back on mitochondrial Health could we talk about some of the um other things that we can do for mitochondrial health things we can take these days we're hearing a lot about creatine what are the data on Creatine and mitochondrial function or brain function I'm not familiar with these data I should be so creatine is a molecule that is foundational to energy transformation in cells so creat goes into the mitochondria and um there it gets combined with ATP to become phosphocreatine and and then it leaves the mitochondrian and goes to places in the cell where energy is needed like a synapse or a ribosome that's trying to make some new proteins or something else it goes to places in the cell where energy is needed and it can be it can combine with ADP to be converted back into ATP so it's basically a phosphate shuttle creatine is a phosphate shuttle that is foundational to energy metabolism it is foundational to mitochondrial function our bodies can produce creatine on their on its own as long we have the essential vitamins and nutrients that make it up and and there are several of those or we can consume Creatine creatine is found only in animal based products animal sourced Foods um it is not found in plant sourced Foods so um what we know is that from because creatine is found in large quantities in the brain so we can actually measure it using mass speec kind of scans and we know that there's a range some people have low levels of creatine and some people have higher levels of creatine people who consume less animal sourced foods like vegans and vegetarians on average tend to have lower levels of creatine in their brain and muscles and other tissues um people with neuros psychiatric disorders schizophrenia Alzheimer's disease depression have been found to have lower levels of creatine than people who do not have those disorders so we have reason to believe that creatine from studies like that that there is an associ ation meaning a correlation between low levels of creatine and brain disorders that we call neurological or psychiatric disorders so the next question logical question from a scientist should be well if we supplement with creatine can that improve symptoms of Neuropsychiatric disorders and we do have evidence to support that not huge randomized controlled trials in tens of thousands of people because again that would require Government funding because creatine is off patent nobody's going to make a lot of money from doing a creatine study because anybody can sell creatine anybody can make it and and Market it it's it's off patent so um but we do have randomized controlled trial data with creatine showing that it can improve symptoms of made major depression it can augment anti-depressants it can improve symptoms of bipolar disorder it can improve symptoms of neurodegenerative disorders like cognition in Alzheimer's disease or mild cognitive impairment but again the studies are on the smaller side they're not super robust quality but unless the government steps up unless the NIH steps up and funds a large well done well controlled randomized controlled trial of creatine versus placebo for any of these conditions the Skeptics and the hardcore scientists are always going to say well we don't have good quality data well we're never going to have good quality data because there's no product that's where we're at as a field do you recommend it to your patients not right away uh you know there's more research coming out um and there's more reason to believe that maybe I should be right recommending it to patients um more often than I currently do uh it certainly lines up with a metabolic kind of mitochondrial improve metabolic Health improve brain health simultaneously It lines up perfectly with that and I just want to remind people before you focus on what to take focus on what you should be doing with your lifestyle what is your diet nutrition are you getting adequate sleep are you getting some bright light in the morning are you do you have relationships and purpose in life um uh are you overusing harmful substances because I want to be the first to say if you're not doing those things creatine doesn't stand a chance in hell of helping your health it just does not stand a chance to improve your health there is no supp that you can take that will undo the damage that a a harmful lifestyle will have on you and your health and um and the reality is the statistics are abysmal I mean onethird of American adults are not getting adequate sleep 60% of the foods that Americans are consuming are ultr processed foods you know the real money is not in the question what should I take the real money is in what should I do how can I change my life and my lifestyle to improve my health and um so I just yeah I just want to drill that home for people for better or worse I first learned about methylene Blue from owning fish tanks you clean fish tanks with them or it's a thing you use um now there's a lot of interest in methylene blue ever since a video of Robert Kennedy putting methylene blue in his water on a plane kind of went viral methylene blue has been around a very long time what are your thoughts on it what does it do is it going to help my a condrea is it for everybody I don't take it I don't take it either and I've not used it in any patients so far but I'm very interested in possibly starting to use it um in controlled ways and patients who clearly need something more we're doing all of the right things we're doing the lifestyle thing we doing ketogenic interventions or other things and they still are not well um there's still room for improvement uh so methylene blue as you said has been around for a long time it's relatively cheap um as a as a fish tank cleaner methylene blue fascinatingly is primarily exclusively a mitochondrial agent so it is an electron acceptor and donor so that is what methylene blue does it can accept electrons and it can donate electrons so it's an electron shuttle if you will and how does that relate to mitochondria mitochondria as they are producing ATP electrons are flowing down the electron transport chain and that is what results in the production of ATP if it gets shuttled through the uncoupling protein it results in heat production um and when electrons flow out of that system when they leak out of that system it creates reactive oxygen species which again are very harmful to both mitochondria and cells so if you have dysfunctional mitochondria that don't seem to be able to contain the elect R appropriately electrons are leaking out so these would be mitochondria that are producing more reactive oxygen species than they should does that ever happen in biology 100% we've got Decades of evidence that aging neurod degeneration even obesity type 2 diabetes and a wide range of neuros psychiatric disorders are associated with that process the in increased levels of reactive oxygen species often referred to as oxidative stress so we got Decades of evidence strongly supporting that um Can methylene blue play a role in that absolutely because methylene blue can come in and take some of these Wayward electrons and prevent them from creating reactive oxygen species which might help calm things down one of the challenges with methylene blue as we discussed before you can have too little and too much same with methylene blue you can have too little and too much you don't want to accept too many electrons these electrons need to be flowing to the places they should be flowing as opposed to oxidative stress the polar opposite of that is called reductive stress and that too has been found in people with schizophrenia and bipolar disorder and some other disorders so it's really about disregulated kind of balance between oxidative and reductive stress and methylene blue if you take it in overdose could become a reductive stressor um so you don't want too much but uh so we do have pilot trials again small not super well done pilot trials and a wide range of neuros psychiatric disorders depression bipolar disorder schizophrenia Alzheimer's disease others many of them suggesting a benefit do you know what the doses range I don't I I don't the top of my head yeah because I because methylene blue as I understand has some Mao activity the um can adjust some of the enzymes that in turn adjust levels of Serotonin um which is why I haven't taken it I've just been cautious about I don't really want to boost my serotonin there's this recent study out of a Lab at Stanford showing that the rewarding properties of various things as we know increase dopamine in anticipation of a reward but also important it seems these are Mouse studies but serotonin drops as dopamine goes up and that drop in serotonin is at least as important as the increase in dopamine for the reinforcing properties of certain behaviors and substances and um I I'm very reluctant to tamper with anything that would raise serotonin because in these studies um or these experiments I or in these experiments I should say increasing serotonin uh offset some of the rewarding aspects of otherwise rewarding things so I want things that are rewarding to feel rewarding and so this this difference between dopamine and serotonin seems pretty vital I mean that's not to say I'm like terrified of anything that increases serotonin but to do it pharmacologically just seems a little little sketchy given I don't have a clinical need that I'm at least not that aware of no well and that's actually one of the warnings with um methylene blue is that if you if taken in to have a dose you can actually get serotonin syndrome could you explain what ser serotonin syndrome is so serotonin syndrome is just like really excessive Deluge of serotonin in the system more often than not it's completely unrecognized really it it gets mistaken for psychiatric symptoms so people can have anxiety they can have panic in extreme cases you can get nausea you can get fevers you can get um I mean in extreme cases it can be fatal so it's a serious thing but more often than not it gets dismissed because serotonin syndrome is most commonly experienced by people taking ssris and by definition they are psychiatric patients or they have a mental health condition and so when they come in and say I'm feeling nauseous I feel anxious I feel jittery I feel I don't feel right they get written off more often than not or giv more medication perhaps yeah let's increase your dose let's increase your dose or whatever so it's actually really tragic I mean one woman actually reached out to me who after learning about my work reading my book she talked to her psychiatrist tapered off all her meds and it became clear that she probably had serotonin syndrome for a long time wow to both her and her psychiatrist so the meds were causing the problem and the meds were causing the problem problem and nobody really recognized it goodness gra again so it's uh so anyway methylene blue can cause serotonin syndrome so I think if people are going to if people want to consider using it I would number one make sure you get a very reputable source of it make sure you're consuming it in a way that makes sense I mean it can stain your teeth blue and all sorts of stuff so your urine blue your tongue blue but um people will do IV infusions of methylene blue so yeah no that's I've seen people kind of hooked up to IVs with a meth a bag of methylene blue do they turn blue and they I hope not Smurf Smurf but it is a medically approved treatment um and I think it can be done in safe ways again it's off patent nobody's going to stand make any money off of doing large welld designed Trials of methylene blue um but I'm really interested in it as uh this as it has these properties in addition to just being this electron acceptor and donor um there's some evidence that it may improve mitochondial biogenesis that it has anti-inflammatory effects and and that it can do other things that that may be beneficial interesting very interesting in fact before moving on to some more clinical questions we've been going deep into the science and some Public Health uh thoughts and Reflections and um ideas there's a supplement called uthan a that people seem really excited about for improving mitochondrial function um I'm not super familiar with the literature um but co-enzyme q12 uthan a we're starting to hear more about these these sorts of things sold over the counter do you have any thoughts on those there's a company timeline that puts out this product and to their credit they have actually done some pretty well-designed robust randomized controlled Trials of urethan a they've primarily focused on muscle health and aging and so actually have reasonably good data published in reasonably good journals um documenting that EUR aithan a when given to elderly people people you know people over 55 65 um that it can improve muscle mass and performance within I think like eight weeks um uh and and that that has overarching metabolic benefits that have you know in terms of biomarkers that have been associated with um slowing of the aging process so um so urethan a I think is definitely a supplement if among all of the supplements that should be considered if people are looking for something to take I'm going to repeat my myself before you take urethan a I've said this to the chief scientific officer of the company um when I was talking with him about this and I said but you know that diet and exercise are much more he said yeah yeah yeah of course like harder to sell people have to do the diet and exercise and everything else but then this could give them an advantage um and I don't deny that at all I think it it may very well give people an advantage um and again the way that I think about it it's not that diet and exercise are going to cure everybody because they won't cure everybody some people are really ill and the way that I think about that is that their mitochondria their metabolic processes are really disrupted they are severely disregulated and that quote unquote healthy diet and good exercise and good sleep and good relationships are phenomenal prevention strategy for some people they can be a phenomenal treatment strategy but I think on average that applies to people with mild to moderate mental health or metabolic health conditions that once once people get into the severe category severe heart failure severe you know mental health condition like schizophrenia bipolar disorder crippling depression um my sense is just a clean diet and good sleep and good exercise is not going to be sufficient and then we do need to start thinking about can we use this supplement or this methylene blue infusion or even neuros stimulation which is can stimulate mitochondria and stimulate neuroplasticity things like transcranial magnetic stimulation yes which is done non-invasively right it is noninvasive and so can we use those types of strategies to try to improve someone's mental health and we've got plenty of evidence that you know especially with TMS that uh it can be very helpful for some people but again is not a Panacea none of these things are a Panacea and although I just said that none of these things are a Panacea so if you're you know people one of the biggest criticis I get is Dr Palmer you have not given me the recipe to cure my crippling ex disorder um and it's like well I I'm trying to teach you the strategies and the science so that you can put together your own treatment plan I am not here to sell any one thing as this is the Panacea to cure all mental illness the ketogenic diet can be lifechanging life-saving it can be nothing short of miraculous for some people but it is not a Panacea I've seen people do ketogenic diets and not get cured not get remission and so I'm always looking for what else what else can we do how else can we use this model to further enhance mitochondrial function metabolic health and the reason I think the reason I'm getting traction is because when you come back to it the we just keep coming back to these like pillars of common sense like for the most part yeah like Diet might actually make a difference to your brain health I don't think it's just Americans I think our species needs to run up against the guard rails at the edge of the cliff six times and sadly see a good number of people go over to their demise before we go wait a second we need to think about how fast we're taking these turns we need to pull back I mean there's something weird about our species that we love to develop technology and then uh and then find the destructive aspects of those technology then pull back and a lot of our you know it's like two steps forward one step back type Evolution it seems inherent to Homo sapiens I'm forgive me for getting so macroscopic here but when you look through I I there's a wonderful book The Prince of men medicine or history of medicine Galen and like it starts there and all the way forward and you read like The what is it the Emperor of all maladies about cancer and you just realize like we're we're stumbling forward and making miraculous progress and at the same time we are seemingly deliberately overlooking a lot of the stuff that's just obvious it's like the the old advice as we exit this conversation about supplements the the the old advice that if you just eat a balanced diet you're good doesn't work anymore I noticed that because quote unquote balanced diet first of all no one can agree on that uh and people get caught up in the vegetarian versus carnivore debates which are really like or vegan versus car which are really at the extremes so we we've lost our our bearings we're kind of like like True North is so clear what true north is it's mostly nonprocessed minimally processed foods getting adequate quality protein you could do that vegetarian you could do that with some animal- based products if you if you choose it's doing that for 90% or 80% of one's nutrition it's exercise we know what forms like all the information's there as you're pointing out but somehow we're just going to have to keep putting it back in our faces um or see enough unfortunate stuff that we we away a second like that this is it's time for a course correction but hey that's what we're trying to do here right absolutely and we have um we have uh colleagues to do it as well and I'll just throw in as long as we're editorializing a lot today I think in The Last 5 Years the discourse around Public Health from the mental health side from the Cardiology side from the cancer side from the long has really transformed in no small part thanks to social media and podcasts so um things are evolving thank you Dr Huber oh well and thank you and thank you vitamin deficiencies and mental health it almost sounds like we're headed deeper into supplements we might touch on that but a few years ago I went to a mcnight meeting and somebody presented some proteomics data where they were sequencing uh spinal fluid from depressed patients and finding that certain depressed patients had deficiencies in certain vitamins that could easily be replaced through supplementation and lo and behold their depressions were in these particular patients were being cured literally reversed going into remission by virtue of taking the appropriate vitamins but the issue was they had to use final tap so it was not in order to know what these patients needed but it was really striking I thought goodness we're talking about B vitamins and depression so um could you tell us about B12 and other B vitamins and uh methylation and folate there's a little cluster of of topics here that I think is super interesting and that people really should know about Visa depression and other CNS challenges before I get into the complex part of the story let me just start with Basics so and this relates to nutrition that a lot of these basic vitamins and minerals um like vitamin B12 folate and iron let I'll just stop there B12 folate and iron these are all essential to mitochondrial function they play a role in numerous enzymes and other cellular reactions outside of mitochondria but they are all Central to mitochondrial function and so if you are deficient in these vitamins your mitochondria will not function properly so it's at least it doesn't prove the mitochondrial theory of Neuropsychiatric disorders but it's consistent with the mitochondrial Theory um and uh and the reality is a lot of Americans are you know a lot of different populations within America and then certainly in other countries can be highly deficient in some of these so um Iron uh you know there's a study in jamama just last year 40% of females aged 12 to 21 in the United States are iron deficient wow it really depends on the definition of iron deficient but their overarching conclusion based on what they thought was a reasonable definition that the journal jamama went ahead and published was 40% of young of girls and young women 12 so this is menstration obviously it's menstruation they are losing blood they are losing blood and they are not consuming enough iron or there's something wrong with the way they're processing iron so let me just stick with that what does that have to do with Neuropsychiatric disorders well boys and girls prepuberty have the same rates of mental illness if anything boys are maybe a little more because they're more likely to have autism and they're more likely to be diagnosed with ADHD so but for for the most part we'll say like depression and anxiety exact same rates puberty hits and girls just Skyrocket the rates of mental illness Skyrocket in girls now are there psychological and social causes of that yes we can talk about your be becoming an attractive sexual mate and maybe people are you know being mean to you or people are you know um making you uncomfortable or you are becoming a victim of sexual trauma do those things happen of course those things are happening could that contribute to depression and anxiety of course that could contribute to depression and anxiety again it's not either or so yes let's stay with the psych ological and social causes but let's also go into the biological causes if these girls and women are now iron deficient that affects their brain function it affects their whole body Health most people don't think of that is a metabolic problem but I do these girls and women can be thin they can be absolutely beautiful and thin and iron deficient and that means they've got a metabolic mitochondrial problem that could be affecting their brain and that could be playing a role in their depression anxiety their you know eating disorder or whatever else they've got vitamin B12 fully we know that low levels of those vitamins are associated with all sorts of Neuropsychiatric disorders B12 deficiency for example um is very common among vegetarians and vegans in India for example where most people are vegetarian or vegan 50% % of their population is B12 deficient whoa what are some food sources of B12 is it is animal Source R red red meat basic animal Source Foods again eggs red meat other types of meat yep be it it you need animal Source foods for the most part or if you're going to be a vegan or vegetarian please take appropriate supplement you can get this in a vitamin but please make sure you're doing it correctly and maybe get your levels measured every now and then at least once a year your annual physical make sure that your doctor knows I'm vegan please do a full assessment of vitamin and nutrient levels for me um because I am at a high risk so B12 is impacted by other medications B12 absorption and interestingly oral contraceptives can reduce absorption of or impair absorption of vitamin B12 interesting met foran can impair absorption of vitamin B12 so just picture a woman who's overweight who's following a vegetarian or vegan diet who's also on Metformin for her diabetes who's also on birth control just because she's at very high risk of being B12 deficient and what does B12 deficiency do in terms of Neuropsychiatric disorders everything it has been associated with higher rates of depression anxiety psychosis bipolar symptoms but people can be hallucinating and delusional from B12 deficiency and the challenge with B12 deficiency is that the neurological damage can become permanent so if this is not recognized and identified early enough people can be permanently injured so that's the simple story some people just aren't consuming enough or they're taking metformin or they're taking oral contraceptives or whatever they're menstruating and they haven't really figured out an appropriate diet to to compensate for the loss of blood um so all of those things can interfere in with vitamin absorption or whatever and can result in neuros psychiatric symptoms unfortunately the story gets a lot more complicated so we've long known that there's an autoimmune form of vitamin B12 deficiency called pernicious anemia in which antibodies to something called intrinsic factor um prevent vitamin B12 from being absorbed in the digestive truck so you could be eating all the meat in the world you're you can't absorb it and you can become B12 deficient that autoimmune disorder increases with age so you could have been living living a happy healthy life and then at age 65 you develop pernicious anemia you can no longer absorb B12 and this is actually one of the treatable forms of dementia that we know of the Cardinal symptoms are look like dementia um and the only way to help these people is if some astute Healthcare clinician measures a B12 level identifies and recognizes the problem and then does further testing for pernicious anemia this autoimmune form of B12 deficiency and then you correct it and the treatment is vitamin B12 injections taking a pill won't work because you can't absorb it so you've just got to inject people with vitamin B12 and it can restore everything for most people will a B12 or supplement work like a methyl a B12 capsule as long as they don't have this autoimmune form yes okay it'll be fine um and again if you're eating lots of meat you may not need any supplement at all so over the last year um there have been a couple of Publications that have just come out that have now recognized a brand new form of autoimmune B12 deficiency and it targets a protein called cd320 which transports vitamin B12 across the bloodb brain barrier the researchers essentially identified this and PE in people who are having pretty severe neuros psychiatric symptom so symptoms of either neurological disorders or other kinds of disorders but mostly focusing on neurology because theur it's neurologists who have been doing all this work when they first identified this antibody they they took blood from these people's veins just like you would if you were going into a doctor for blood draw the B12 levels are normal everything's normal in the periphery because the person may be consuming enough B12 and it may be getting absorbed fine so they're not anemic they show no signs of B12 deficiency but when the researchers tested their cerebr gr spinal fluid they had almost no B12 in their central nervous system so that requires a spinal tap right this is not in order to diagnose it it required a spinal tap and um they ended up treating some of these people with immunosuppressive agents to reduce this autoimmune condition and high does vitamin B12 and some of the people had reversal of symptoms meaning their neuros psychiatric symptoms went away the research is still in preliminary stages but the researchers have looked at how common is this because at first glance it sounds like well that's just a really rare condition that can't be relevant to human health they sampled just a general healthy control and about 6% of those people have this antibody wow it's really high they then sampled people with neuros psychiatric lupus so these are people who have an autoimmune disorder already lupus and they have neuros psychiatric symptoms 20% of them had this antibody and then they just recently this is unpublished data but they have looked at people who have a demyelinating condition of unknown iology and about 50% of them had this anti 5% so this is like an MS like condition had this antibody and what's the solution B12 the reason this is of interest to me and we're hoping to do some research on this in patients with psychiatric disorders is because there is a treatment immune supressive kind of treatments to either reduce this autoimmune condition and or high does vitamin B12 injections so you want to flood their system with vitamin B12 so that some of it can get across the bloodb brain barrier and again oral B12 won't work in this case right oral B12 may very well work in that case um but I would actually I mean in these situations what we know is that these people's brains are being damaged from severe B12 deficiency so I would probably just go for the definitive massive injection and try to try to rescue those brain cells this is very interesting I think um people should get their B12 levels measured um a standard blood test right um it is unfortunately for this new autoimmune Central B12 deficiency they're they're working on a commercial test but you can't get this blood test right now okay um so uh perhaps to come stay tuned but I the point of it is this that I think for the majority of people 60 to 80% of people who are suffering from neuros Psychiatric disorders I actually think using interventions that are easily available today will help them heal and recover I really believe that I I stand nothing I don't get any money from lifestyle interventions I don't get a commission for everybody who does a ketogenic diet in theory you'd have few to treat in theory you lose money because you have lose money by by getting people better and then they move on and don't need me anymore um I honestly believe that but I also believe there will be 20% maybe up to 40% who have severe disorders for whom those strategies just won't work and so I'm really interested in well what else could it be and this is just one of many examples of what else it could be they could have an autoimmune form of central B12 deficiency and why does that matter because we can test for that and if if they have that we can treat it there's a clear unequivocal treatment and you know at the end of the day I think one of the biggest themes of my work is that right now in the mental health field we assign these diagnostic labels to people and for many of them they become life sentences you have schizophrenia that's a lifetime sentence it's probably never going to get better you certainly always have to take medicines for the rest of your life you have bipolar disorder it's for life you have chronic depression sorry we just don't know how to treat it depression should go away but it's not going away for you we don't know what to do sorry so sorry I know that you know on the surface it may sound like well those are just rare people Chris they're not rare people hundreds of millions of people on our planet are given these life sentences and we assume that we now know the cause the cause is you have schizophrenia that's the cause and in fact schizophrenia is only a label of symptoms schizophrenia means a person who has chronic psychotic symptoms of unknown ideology of unknown ideology because if we know the ideology you don't call them schizophrenic anymore you say they have vitamin B12 deficiency and psychosis or you say they have an autoimmune disorder like lupus and psychosis and why is why is that so important because there's a treatment for these other things other than just antis psychotic medicin and what I really hope and implore our field will do is we will come into the 21st century and begin to recognize that there is a cause of schizophrenia there is a cause of bipolar symptoms there is a cause for chronic depression and that we will will begin to look for those causes and we will begin to treat those causes as opposed to just putting people on anticho or anti-depressants or mood stabilizers and telling them well we're really sorry we know these medicines don't cure your illness we know these are not disease modifying treatments we're really sorry we can't do better you're just going to have to suffer for life like we can do better and I applaud your efforts to bring about that change I mean I think people realizing that often not always but often mitochondrial dysfunction is at the heart of of these things um is critical um speaking of which I have to ask and feel free to pass on this question if if you like but um I become very interested in vaccine biology and the debate about vaccines about the adant that are used to deliver the vaccines there a um obviously there's a very contentious topic I just want to know without being I'm not trying to be Pro provocative here um is there any evidence that vaccines or the adant um for vaccines or anything about vaccines and their delivery can disrupt mitochondrial function you know so often we think that it's like the vaccine having a specific effect on what the vaccine was designed to Target that could potentially cause side effects or something like that that's what many of the theories hold but given um the key role of mitochondria in all aspects of brain functioning and given that some people are convinced I'm not saying I believe this but are convinced that vaccines are tied to these mental health challenges or to autism let's be direct about this is there is there any evidence that vaccines can of any kind can disrupt mitochondrial function or support mitochondrial function for that matter it is a contentious maybe it's a different episode no no no definitely I'm I'm definitely going to answer it but I'm going to give a long-winded answer if that's okay because I because I want I want to give credible information that's the only information we're interested in and I don't want to come down on one side that vaccines are 100% safe there's no question about it or yes vaccines cause autism and that's why we've got Sky recing Ras of autism because I don't think either of those extreme positions is true so I want to First back up and just ask a slightly different question is there any evidence that high levels of inflammation impair mitochondrial function the answer to that is unequivocally yes high levels of inflammation inflammatory cyto kindes like tnf Alpha inner Lucan six and others impair mitochondrial function we know that it is clear and unequivocal um and there are physiological reasons for it the the organism has to adapt so when you have the flu do you have Neuropsychiatric symptoms yes you do you're going to feel exhausted you're going to be less risk-taking you are not going to want to reproduce more than likely you're going to completely lose your libido completely lose it like zero interest and what are you going to want to do you're going to want to hide in bed and pull the covers over you and just retreat from the world for safety those are all effects on your mood your motivation rewarding behaviors all sorts of things the inflammation the infection is doing that to you and we know that it's inflammation because this happens with cancer it happens with treatments that cause inflammation if we give treatments that cause high levels of inflamation people experience these symptoms acutely if we give interfer on for example which can be a treatment for some disorders people will acutely develop all of these symptoms so we know that interferon itself will produce all of these Neuropsychiatric symptoms we also know from basic cell biology interferon interferes with mitochondrial function we know that it is unequivocal we now let's go to autism is there any evidence that inflammation can lead to autism we have Decades of evidence for this we know that over the course of the last century as there were kind of outbreaks of bacterial or viral infections in the population we saw higher rates of neuros psychiatric neurodevelopment mental disorders in The Offspring of the pregnant women so we've long known that and that evidence is pretty well established for instance uh forgive me but the one that I'm aware of is that flu in pregnant mothers at the first to second trimester transition is correlated with statistically higher incidents of schizophrenia in The Offspring do I have that right that's correct okay but then there there was a rubella outbreak that resulted in much higher rates of autism in The Offspring um that I think that was in the 1960s um and now we have really Decades of animal models so they take mice and they inject them with lipopolysaccharide which causes an inflammatory reaction and when they do this to pregnant mice the the the mice that are born to those women those those female mice are at much higher risk for showing signs or symptoms of what looks like a neurodevelopmental disorder um it's it's different diagnosing or whatever a neurodevelopmental condition in a mouse is it 100% no it's just we increase the risk so if you inject a pregnant Mouse with lipopolysaccharide can she can that Mouse still have a normal appearing Mouse yes but can't but the probability that The Offspring will have a neurodevelopmental symptoms of a neurodevelopmental condition increase that is where so much of the autism research has been focused is trying to understand this trying to understand what is happening with inflammation how does that impact neurodevelopment we know that so now back to the question that you posed is there any possibility that vaccines could contribute to that process do vaccines increase inflamation I think the answer to that is yes is is there variation in the inflammatory response between different people I think the answer to that is yes can some people have a hyper exaggerated inflammatory response in response to a vaccine I think the answer to that is yes in that condition so in that rare less common condition where somebody is having a hyper exaggerated inflammatory response to a vaccination could that impact neurodevelopment the science right now says yes we have no reason to think it wouldn't there's one case of a young child who already had an existing mitochondrial disorder it was already known she got vaccines and I think within days or weeks of getting the vaccinations she developed profound neurodevelopmental symptoms that case won a lawsuit that went to court it was tried in court and she won and the Court ruled that the vaccine did in fact contribute to this girl's neurodevelopmental condition now they assumed it was because she had a pre-existing mitochondrial disorder um and I would support that it lines up perfectly with what I've been talking about all along um that people who have vulnerabilities with mitochondria or metabolism you can only absorb so many hits and when you get that final hit that tips kind of the balance um to impact neurod development you can get that when now coming back to the bigger question so should people get vaccinated or not we do have reasonably good evidence that unvaccinated people are more likely to develop autism than vaccinated people is that right the problem with that study is that it's an it's a retrospective cohort epidemiological study and the biggest critique that I have of that type of research is that the researchers decide what they control for and what they don't control for but the existing research right now as published and as designed suggests that if you don't get a vaccine you're more likely to develop autism than if you do get a vaccine and how would I understand that I just talked about infections themselves can cause neurodevelopmental disorders so if a child gets measles they're not only at risk of dying of measles they're also at risk of impacting their mitochondrial function and developing a neurodevelopmental disorder as a result of getting a severe infection assuming there's choice there's a risk benefit in analysis do you do you want the the uh the potential inflammation from the vaccine or lack of infl you run the gamble it's hard to predict who's going to have a big inflammatory response and who's not although I'm thinking in the back of my mind about these lifestyle factors even though it's a young child or a or um an adolescent in some cases but but young children typically there are things that you can do to bolster the the uh the health of that kid going into a vaccine if you're choosing to vaccinate your kids right like proper sleep proper nutrition proper proper everything you wouldn't want them even slightly sleep deprived because that would uh increase the risk of inflammation right I mean these things compound as I understand it um so you know I think what most all parents really want is a sense of control over what are inevitably a mixture of controllable and uncontrollable factors and this is what I hear when I really listen to this debate about vaccines I hear my science colleagues inevitably saying okay the Wake field data or BS Etc like no no no there's no possibility and then I hear parents who are having kids whose kids are due for vaccines and they're like I don't know what to do they're they're terrified and these are smart people and they don't know what to believe anymore that's the challenge I mean the science that I just laid out is true it's clear um and again we've got Decades of research to support most of what I've just said all of what I've just said I think um if you understand the biology when a child begins to show symptoms of a neurodevelopmental disorder instead of assigning a label this is autism it's a life sentence good luck we should be intervening and what could we do to intervene what you just said in terms of prevention strategies absolutely let's make sure that even before you're going to the doctor even before you're exposing yourself to any of these vaccines that you're healthy why because we want you to be healthy why wouldn't you want to be healthy so let's just be healthy but I would actually go much further and say as soon as a child begins to show signs or symptoms especially when it's an Abrupt change when they were developing in a neurotypical way and then all of a sudden they got an infection or they got a vaccine or something happened and now they are falling off the trajectory and that's what we hear from these parents who are saying No this is real this is that's why they believe vaccines cause it do I think it was just the vaccine on its own I suspect a lot of them have had other hits they probably had other vulnerabilities going into that vaccination and that the vaccination if we even entertain the possibility that That vaccine did contribute to their autism I'm doubtful that it was the sole only cause I'm doubtful it was the sole cause but regardless once the kid starts showing signs or symptoms we should be doing a full workup we should be looking for vitamin and nutrient deficiencies we should be looking for this Central B12 deficiency did the vaccine somehow cause an autoimmune reaction to cd320 so that now this kid has Central B12 deficiency and that is why this kid is falling off the chart um should we entertain a ketogen diet for this child I would say yes we should that should be on the table of options um we might want to put this child on a ketogenic diet does that ever happen it happens all the time in kids with epilepsy so why not do it for neurodevelopmental conditions but again it's not just keto diet is going to save the day and we don't have to think about Central B12 deficiency or any of these other things like let's put it all together and especially with AI now now we can do this this is a solvable puzzle it is a complex puzzle no doubt but it is a solvable puzzle and we should start to solve it but right now the state of the field is that we assign a label autism and we tell the parents to just prepare for a disabled child just prepare yourself to take care of a disabled child for life we're really sorry we don't have anything more to offer we can do some ABA training we can do some basic you know we'll try to teach them some social skills the the the real outcome data on that is pretty bad if if your brain's not working right it's hard to teach people how to have how to do the skills that the brain is designed to do and that's the challenge is that um it's all well and good to recognize a problem but now we need to come up with effective treatments and we know that a lot of the you know people talk about early intervention with autism as though early intervention is going to save the day I don't mean to bash the people doing that work let's do anything we can it might help a little but when you look at the outcome data it's not helping much and when you look at the statistics of the prevalence of autism it's going through the roof so those strategies are just not working they're not working for prevention they're not working to improve long-term outcomes they're not I mean we have a lot of work to do so I appreciate the thoroughness of your answer I can um promise you that uh anything we put out about that will include the full context we're not we're not people will take the sound bite and well if they do I'm going to get I'm going to um get rabid um by posting the Preamble because it's very important people hear the full context it's um and I I really appreciate you uh embracing that topic with the the depth and rigor and uh sensitivity also that that you do uh because I don't think we can um duck this vaccine question anymore um I never thought in my lifetime that vaccines would be a thing it's like when I was a kid everyone got the polio vaccine the measles vaccine and he kind of went about our way I do understand the number of vaccines that kids are getting now like the vaccine schedule has expanded um uh yeah I've been um kind of thrown into the middle of this as different guests have come on this podcast who've said they do get the flu vaccine others who say they don't and you know gosh if ever there was a separator besides Democrat versus Republican it's this vaccine thing um it's really like the separator uh is it's it's so closely tied to um believes in science doesn't believe in science like that's those are the stereotypes right or um suspicious of science NIH and CDC or believes in science NIH and the CDC wholeheartedly like the The Divide is very Stark and this needs to stop like the Divide needs to stop we we need to start filling in with answers um and I think there's soon to be a exploration uh a scientific exploration of the relationship between vaccines and autism I read this someplace on X which means but I think that's the idea and I think some people kind of upset that this that resources were going to be devoted to this because they felt like it was it was a done deal and then others are very excited because they feel like Hey listen if if you don't think there's a a link then there here's an opportunity to to establish that with with real rigor and I think everyone's just really interested in the the stud being done properly I look I think more data is always great I don't disagree i' and I've I've actually talked to some former nmh directors about this and some other leading people in this field and there's no doubt that this topic has been brought up multiple times at the NIH so there's this inter agency um Coordinating Committee um on autism uh within among all of the NIH kind of centers and institutes that's existed for decades they have looked into this issue um I've talked to some autism Advocates who've said like I was hoping that vaccines might be the cause like I was really hoping to see that vaccines are the cause because that would then give us a cause and it would lead us to interventions um to make vaccine safer or whatever um and she said but it's just not there it's just not there and this former NIMH director that I spoke with it's just not there Chris it's not there um we looked we looked high and low um again I'm not sure that everybody looked with the same degree of scrutiny again the study that I saw looked at people who are unvaccinated by choice so these are rebellious people who are defying state laws who are risking not getting their children into school because they're not getting vaccinations that's the cohort of unvaccinated people um and then they're comparing them to the cohort of vaccinated people and they only controlled for like a like two or three variables they did not control for obesity they didn't control for diabetes and we know that obesity and diabetes play a role in risk for autism and we know know that people who have existing health conditions might actually be more likely to be worried about vaccines and then not get vaccines perfectly happy healthy thriving people usually just go along with status quo they usually don't refuse vaccines so people who are refusing vaccines probably had some pre-existing health condition they didn't control for that did that pre-existing health condition increase risk for or Autism probably well if there's an inflammation link then yes like like probably I mean you look at any pre-existing health condition and does it increase risk for other health conditions usually the answer is yes so we know that like women with obesity much more likely twice as likely to have an autistic child is that right yeah meta analysis over three million people women with obesity have doubled the risk of having an autistic child have rates of obesity been skyrocketing in our population the answer is yes are pregnant women also in that camp of obese women yes well that accounts for a doubling of autism same deal with um diabetes women who have diabetes twice as likely to have autistic children is women who don't have diabetes when you put the two together obese and diabetic quadruple the rate of autism in The Offspring what about dad you know there are these theories about the statistically significant increases in rates of autism for offspring of um men who are 50 or older my read of the data uh is that it's still a very small increase it's not like the kind of increases you're describing here for diabetes it is so men with obesity twice as likely to have an autistic child as men who are not obese yeah which is which is um something like 25 times greater than the increase due to age of the male so this is so important because people hear oh you know uh older sperm equals higher probability of autism but yes still a very low probability of autism compared to Dad is obese but in his 20s or 30s yes and so you know a lot of people are hyperfocused on vaccines cause autism and they come back to rates of autism are skyrocketing there has to be a reason well I agree rates of autism are skyrocketing I agree there does have to be a reason maybe we're missing the elephant in the room rates of metabolic poor health are skyrocketing in our population rates of obesity and diabetes are skyrocketing but rates of poor metabolic health so metabolic syndrome has five biomarkers you know abdominal obesity blood pressure um uh glucose high levels of glucose and then high triglycerides and low HDL cholesterol those are the five biomarkers of metabolic syndrome only 7% of Americans are healthy in all five biomarkers yikes only 7% po or metabolic Health influences neurodevelopment and Offspring we know that so we've we see skyrocketing rates of autism it's not just autism we see skyrocketing rates of ADHD as well simultaneously and everybody's scratching their heads trying to figure out where's all this autism coming from where's all this ADHD coming from well look around people as the metabolic health of the United States population declin we are going to see more neurodevelopmental disorders such it's a critical message but also reassuring in the sense that we can do something about it we can because what you're talking about is metabolic dysfunction mitochondrial dysfunction of the parents right um so you know trying to control the uh the behavior of still unborn um or yet to be see children is pretty tough to do and um and yet anyone thinking of conceiving um should really pay close attention to their metabolic health is clearly the message I think obesity becomes a little bit of a um of a of a critical Factor yet a distractor that wasn't meant to rhyme uh for when we hear metabolic health I think a number of people hearing this will say well I'm not overweight so my mitochondria are probably healthy but what you listed off included high high triglycerides um you said blood pressure which you know there are some thin people or you know non apparently obese people it's I say apparently obese because a lot of people are carrying higher body fat percentage than they realize even though they're they're not you know taking up a lot of space um so I think you know uh it's not always and low HDL so sometimes um you know we're shocked to see like oh this person is like apparently healthy but has you know low HDL and is got their apob is through the roof and they're they're not well but just because they're not obese doesn't mean they're metabolically healthy correct that is absolutely correct and I go back to some of our prior conversation so a 14-year-old girl who is severely iron deficient is metabolically unhealthy why because our mitochondria can't function properly without iron she can be [Music] thin she can otherwise look like a healthy attractive girl but she can be metabolically unhealthy because she doesn't have all of the essential vitamins and nutrients that she needs to have properly functioning mitochondria and metabolism and why would that matter it matters because she might develop an anxiety disorder or she might develop depression or she might develop symptoms of an eating disorder and then we're all scratching our heads giving those labels oh you've got depression you've got anxiety you need Prozac and maybe she really needs iron right I mean what I realized and and this was really where I wanted to bring us to um is a question for you I have an idea but a let also posed the question as an idea and feel free to bat it down I'm beginning to think that in order to get out of this health rut that we're in that clearly relates to mitochondrial dysfunction and at the same time there are tools the lifestyle tools that you described there are yes there are supplements and maybe methylene blue will be advantageous and methyl B12 perhaps but certainly the lifestyle factors most people again when they hear metabolic Health they just think okay metabolism obesity thinness or fatness and and they it sort of becomes a a gravitational pull towards that do you think it's possible to create a metric I don't want to say BMI as an example because that's controversial for some people but is it possible to create a metric of allaround metabolic Health um that would be incentivized so that people can live better lives their offspring can be healthier as well and we can unburden the Health Care system and and potentially avoid Millions and millions of people having these so-called incurable mental health disorders in air quotes you know what you're describing is kind of in my mind um a really important next step and the great news is that there are several research groups that I know of that are working on exactly that one is a commercial company I'm not going to name any names but one is a commercial company that has a a a product of a series of biomarkers blood biomarkers that they believe represent ultimately mitochondrial dysfunction all of the different cellular Pathways that can result in mitochondrial dysfunction and or can reflect mitochondrial dysfunction and um and they believe that their test might be able to predict the development of autism that every child at age one should get this blood biomarker and it will tell us who's at high risk of developing a neurodevelopmental disorder the test itself doesn't tell us what's wrong it just tells us something's wrong and then the clinicians need to go to work and try to figure out what is going on what is causing this metabolic mitochondrial disregulation so that we could potentially intervene I've talked with one of the leading mitochondrial researchers really in the world he's got a set of 20 biomarkers that he believes represent mitochondrial dysfunction broadly and then there's another research group um that is is actually narrowed it down to just five different biomarkers in men and five slightly different there's some overlap but slight differences in women and those five biomarkers alone were able to distinguish people with chronic severe suicidal depression from healthy controls with over 90% sensitivity in specificity wow so I think that is one of the directions we need to go is we need to establish tests with all of these groups I want to just state state clearly and plainly because one of the common questions I get is what's the blood test I can get for my mitochondrial Health there isn't one um that's the answer there is not one there are lots of different biomarkers that can suggest disregulation of metabolism and mitochondrial function um and again these three research groups are all working on it you know in order to get those five biomarkers for men and women they I think they measured 400 different biomarkers um so we need to make sure that that gets replicated that it's you know prospectively it can identify people um I'm I'm less concerned about kind of the incentivizing and let's give insurance discounts and other things I actually think the majority of human beings that I know authentically want to be healthy and they authentically they really want to have healthy children they will do anything to have healthy children so I don't think we need necessarily need to come up with some incentives right now I I think if we develop evidence-based tools that prospective parents can use to assess their own metabolic MIT andrial health and more and maybe maybe more importantly assess their prospective Children's Health and then we pair that with evidence-based strategies to help them improve their metabolic health so that it will improve the outcomes for those children I mean that's the Holy Grail what I just said probably represents Decades of research the sooner we get started the better and some of it's already underway as I've mentioned so it's not like we start from Ground Zero people have been on this Trail for a while um so but it is going to require a concerted effort it's going to require massive NIH funding to support that type of research we have a new Administration that is talking about massive disruption and the way things are done they're talking about massive changes at the NIH I am really hoping and praying that we're going to see that type of research as opposed to the current model of research which focuses on well here's your diagnosis schizophrenia or hypertension and what what new pills can we develop to treat this condition or how can we understand this condition it like I I think we have enough evidence to be able to really start with more effective to be able to really aggressively pursue more effective treatment and prevention strategies fantastic what role do you see yourself in going forward I mean clearly public education about these issues related to metabolic and mitochondrial Health um is a wonderful home for you in addition to all your clinical work and and everything else you're doing this uh you're clearly very passionate about it um if I may ask you do you have plans to get involved in helping the new NIH new uh Health and Human Services folks you know Steer in the right direction I am more than happy to serve as a consultant if asked and I have I have had some conversations with a wide range of people um so I'm more than happy to do my part I think for the iMed imediate future honestly I am I'm focused on some of these lines of research through mlan hospital and Harvard Medical School I'm really aggressively working on setting up a Health Care System practice to start where we will treat people with these severe chronic mental health conditions that I started a weight list about a year ago and I have over 5,300 people on my waiting list wow I can't treat 5,300 people but I have the privilege of a lot of brilliant clinicians are reaching out wanting to work with me what I'm hoping to do is to put into practice into real world practice everything that we've talked about and more with real human beings to demonstrate this really does work it really does work and I've been doing this work as a solo clinician for 30 years now um and I welcome the opportunity to begin to develop protocols and processes and use artificial intelligence to really try to create algorithms if we can do that um then yeah we hold the potential to help Millions if not billions of people and uh and I you know the theory is great and I'm really a big fan of the theory I it continues to line up new evidence since I've published the book new evidence has come out just completely supporting it and if anything bolstering it putting it into actual clinical practice is really where the rubber Meats rolled Road and um and as we've just talked about there are so many things we can do for people who are suffering today and uh I'm I'm probably it's not even probably I'm most excited about that I'm most excited about training other clinicians and demonstrating for the world that this really works that people can get better from severe treatment resistant mental illnesses fantastic well I and everyone else are super grateful for your real enthusiasm and like clear Devotion to that last statement and um you know I'll finish today's discussion with where we started which is to say thank you for being such a Pioneer for this clearly New Direction for mental health and for Bridging the Gap between mental health and physical health and clarifying for all of us today what you mean what people mean when they say metabolic Health we really have to think about mitochondria what they do the many many roles they play in cells and are everywhere in the body and the paths to improving mitochondrial Health lifestyle supplement in some cases drug- based you know um and the preventative care that we can take especially for people that are thinking of conceiving children to get their metabolic Health right but also of children regardless of age and also for your public health work I mean you really put yourself out there you were willing to embrace this uh vaccine question and did it with with an Inc with Incredible um care to to all sides um and at the same time staying really close to the data in hand and offering new questions so that just is uh emblematic of of everything you do Chris and um it's such a pleasure and an honor to have you back again and uh if people um want to reach you uh we will provide portals for that I know there's a lot of Outreach towards you I really also appreciate seeing you on social media on X and on Instagram it is really important that people hear from you and then what's lovely also is that uh as new studies come out that agree or disagree with with some of the things that have been said today you're always one to uh to put those out there and and and address considerations and get people excited but appropriately excited or cautious but appropriately cautious so thanks for everything you're doing far too much to list again right now um hope to have you back again because the progress is is happening so rapidly um in the meantime thanks for this incredible voyage and uh education for me and everyone listening you're doing God's work thank you thank you Andrew and thank you for doing everything you're doing you're also doing God's work and uh and I know that uh yeah what you do is not always easy and trying to give actual practical protocols so to speak uh is really important and you're probably doing more for the mental health field I don't know I'm struggling to think of who's doing more for the mental health field and the mental health of millions of people around the world than you right now I'm I'm hardpressed to think of someone it's a collective effort folks like you and and the people that come on here you know so I consider you a colleague and a and a and a um comrade for lack of a better word we had a Russian on here recently so comrade um in that uh effort yeah thanks I you know think I know how much you care and I care too so thanks for those words thank you thank you for joining me for today's discussion with Dr Chris Palmer to learn more about Dr Palmer's work including his research and his clinical practice and his absolutely spectacular book Brain energy please see the show note captions if you're learning from and or enjoying this podcast please subscribe to our YouTube channel that's a terrific zeroc costway to support us in addition please follow the podcast by clicking the follow button on both Spotify and apple and on both Spotify and apple you can leave us up to a fstar review and you can now leave us comments at both Spotify and apple please also check out the sponsors mentioned at the beginning and throughout today's episode that's the best way to support this podcast if you have questions for me or comments about the podcast or guests or topics that you'd like me to consider for the hubman Lab podcast please put those in the comment section on YouTube I do read all the comments for those of you that haven't heard I have a new book coming out it's my very first first book it's entitled protocols an operating manual for the human body this is a book that I've been working on for more than 5 years and that's based on more than 30 years of research and experience and it covers protocols for everything from sleep to exercise to Stress Control protocols related to focus and motivation and of course I provide the scientific substantiation for the protocols that are included the book is now available by pre-sale at protocols book.com there you can find links to various ERS you can pick the one that you like best again the book is called protocols an operating manual for the human body and if you're not already following me on social media I am huberman lab on all social media platforms so that's Instagram X threads Facebook and Linkedin and on all those platforms I discuss science and science related tools some of which overlaps with the content of the hubman Lab podcast but much of which is distinct from the information on the huberman Lab podcast again it's huberman lab on all social media platforms and if you haven't already subscribed subribe to our neural network newsletter the neural network newsletter is a zero cost monthly newsletter that includes podcast summaries as well as what we call protocols in the form of one to three page PDFs that cover everything from how to optimize your sleep how to optimize dopamine deliberate cold exposure we have a foundational Fitness protocol that covers cardiovascular training and resistance training all of that is available completely zero cost you simply go to huberman lab.com go to the menu tab in the top right corner scroll down to newsletter and enter your email and I should emphasize that that we do not share your email with anybody thank you for joining me for today's discussion with Dr Chris Palmer and last but certainly not least thank you for your interest in science [Music]