39. Dr. Chris Palmer: Can Fixing Your Diet Help Treat Mental Illness? The Science Says Yes!

Have you ever felt like mental health care is stuck in the past? Why are rates of depression, anxiety, and even conditions like autism skyrocketing in today's world? And why does traditional treatment often fall short? Spoiler: the answer lies deeper than just brain chemistry… it's all about your metabolic health. In this week's episode of Extend, I'm joined by Dr. Chris Palmer, a psychiatrist and author of Brain Energy. Together, we're unraveling the powerful connection between your metabolic health and your brain, exploring how poor nutrition, environmental toxins, and lifestyle choices are driving the modern mental health epidemic. But this isn't just a conversation about problems, it's about solutions. Dr. Palmer shares groundbreaking insights into how addressing metabolic dysfunction can lead to dramatic recoveries for people with conditions once thought untreatable, like schizophrenia, bipolar disorder, and severe depression. Dr. Chris Palmer is a Harvard-trained psychiatrist, researcher, and the author of Brain Energy, a groundbreaking book that challenges conventional views on mental health. His work integrates cutting-edge neuroscience with practical, science-backed strategies to heal the brain through nutrition, lifestyle, and metabolic therapies. If you're ready to transform the way you think about mental health and learn actionable steps to heal from the inside out, this episode will give you the hope and tools you need. Let's dive in! We Also Discuss: (00:08) Mental Health Epidemic and Root Causes (16:00) Metabolic Health in Mental Wellness (33:38) Metabolic Health and Neurodevelopmental Disorders (44:46) Holistic Approach to Mental Health (59:26) Lifestyle and Metabolic Health Strategies (01:13:16) Personal Stories of Dietary Transformation (01:24:03) The Power of Metabolic Health Thank You to Our Sponsors: TruNiagen: Whether you are looking to stay sharp, feel more energized or simple age better, go to https://www.truniagen.com/ IFit: If you are looking to elevate your home gym fitness experience with the best in fitness tech, choose IFIT. Go to https://www.ifit.com/ Nexthealth: NextHealth: Your destination for cutting-edge health optimization—from IV therapy to hormone balancing. Explore at https://www.next-health.com/ Vitaboom: Vitaboom: For supplements you can trust and wellness solutions tailored to your health, visit https://vitaboom.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/ Learn more about Dr. Chris Palmer: Website: https://www.chrispalmermd.com/ Instagram: https://www.instagram.com/chrispalmermd

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:50Dr. Darshan Shah?

  Have you ever wondered why mental health treatments seem stuck in the past, offering just Band-Aid solutions like tons and tons of medications, instead of truly healing the mental disorder? What if conditions like depression, anxiety, and even schizophrenia aren't just disorders of the brain, but actually symptoms of something much deeper that is occurring throughout your body? In today's episode of Extend, I'm joined by one of my favorite physicians, Dr. Chris Palmer. He's a Harvard psychiatrist challenging everything that we thought we knew about mental health. He's here to share his groundbreaking research and insights from his research connecting metabolic health to mental illness, and why treating the body can be the missing link to healing the mind.

• 1:34Dr. Darshan Shah?

  We're going to dive deep into the science of how blood sugar imbalances fuel anxiety, how nutrient deficits might exacerbate depression, and even how your mitochondrial dysfunction could explain diseases like schizophrenia. Dr. Palmer shares powerful, real-world stories of patients who transformed their lives by addressing their metabolic health while they were treating with medications, and actually got off medications over time. So if you've ever felt frustrated with traditional mental health approaches, or you've wondered if there's a better way to handle mental health, this conversation could change how you view your body, your brain, and your well-being forever. I can't wait for you to hear my conversation with Dr. Chris Palmer.

• 2:19Dr. Darshan Shah?

  Let's get into it.

• 2:25Dr. Darshan Shah?

  Dr. Palmer, I'm so honored that you joined me on the Extend Podcast today. Thank you so much for coming.

• 2:31Speaker 01

  Thank you, Dr. Shaw, for having me on.

• 2:33Dr. Darshan Shah?

  Ever since I met you in April, you know, I put on the health conference that you spoke at, I was just so struck by how passionate you are about mental health. And you come from a place of really wanting to see change happen, and I really appreciate you for that. And having a different approach than, you know, I trained in medicine and one of the rotations that we did was in the psychiatry ward. And I just remember, everything just seemed so futile to me. I just got this general feeling that what was happening with mental health, just for whatever reason, didn't seem to work very often. And your new approach, or you're just a new way of thinking that you bring to the field, it just completely speaks to me.

• 3:15Dr. Darshan Shah?

  And I can't wait to have that discussion with you here, so more people can hear this, because it's so hopeful. I really appreciate that in you.

• 3:24Speaker 01

  Thank you.

• 3:27Speaker 01

  Yeah. You know, it's interesting. I'll just say, you know, a lot of people are passionate about mental health. And for me, it really is, starts off very personal, with my own struggles with mental health, with some family members, my mother, and others who've had very severe, crippling, disabling, life-ruining, mental illnesses. And so I've been on both sides of that kind of relationship. I've been a customer, or consumer, patient, whatever you want to call it. I've been really frustrated with the lack of efficacy, with all the side effects, with

• 4:05Speaker 01

  all the challenges to the diagnostic labels, with this haphazard, just will randomly try different medicines to see which one might work for you. Well, what science are you using to make that decision? Oh, we don't have any science for that decision. We just randomly choose one pill. And if that doesn't work, then we try another one. And if that doesn't work, we try another. But I've also seen lives devastated, like people that I love and that I depend on, their lives are devastated. And then, and then I've been a psychiatrist for almost 30 years. So I've been on the other end of that. Relationship where I'm the one delivering these futile treatments.

• 4:47Speaker 01

  I'm the one that people are really angry at and frustrated with. And why aren't you curing my son, Dr. Palmer? Why aren't you curing this person? And I think that this new way of understanding mental illness, you know, in one way, it really is strongly about science. It's about integrating decades and decades of neuroscience, genetic research, cell biology research, brain imaging research. It's about putting it all together. And some of the treatments and solutions are actually quite common sense

• 5:31Speaker 01

  and accessible and understandable, even for people who don't want to understand that science. And the reality is we can really transform lives, not just for people with depression or anxiety. Yes, we can do those. Those aren't necessarily revolutionary to a lot of people. But we're transforming the lives of people with schizophrenia and bipolar disorder, which are largely thought to be incurable and untreatable. And the best we do is we manage these illnesses. But these people are going to be, their lives are ruined forever.

• 6:06Dr. Darshan Shah?

  Right, right.

• 6:07Speaker 01

  And we're seeing dramatic recoveries in people.

• 6:13Dr. Darshan Shah?

  That's incredible. I can't wait to dive into what you're doing, the science behind it. But before we do that, I think it's important to kind of frame the picture. And you do an eloquent job of this. Can you answer the question? What is the current status of mental health in the Western world?

• 6:28Speaker 01

  So the unfortunate news is that we do have a mental health epidemic, for people who may not know that. The latest estimates are about 1 billion people on the planet suffer from a mental disorder in any given year. That represents about 13% of the world's population. In Western countries, the rates are higher. It's about 1 in 5 people, 20% of people, will suffer from a mental disorder in any one given year. If you look at lifetime prevalence, it's about 50%. 1 in 2 people will meet criteria for a mental disorder at some point or another during their life. Now, sometimes, those are easily understood situations.

• 7:11Speaker 01

  You break up with the love of your life, and you get depressed for more than 2 weeks. Not rocket science. Right. People, when they're in college, might actually meet criteria for a substance use disorder. They're binge drinking multiple times a week because they're partying. Technically, they meet criteria for a substance use disorder. Do they think of themselves as having a mental illness or a mental health condition? No. The reality is that the rates have been dramatically escalating for the last several decades. So, in the last 20 years, the rates of autism have quadrupled, the rates of ADHD have tripled,

• 7:56Speaker 01

  the rates of major depression have reached an all-time ever-recorded high, both in terms of current prevalence and lifetime prevalence. Rates of eating disorders, in the UK, where we have good statistics on this, the rate of hospitalization for life-threatening eating disorders is up fivefold in the last 20 years. The rates of opioid overdose deaths massively up, a fivefold increased risk. So, the rates of bipolar disorder in adults, largely thought to be a genetic disorder, the rates of bipolar disorder in adults have doubled in the last 20 years, and in children and adolescents, they're up through the roof. So, there's a broad range of mental health conditions.

• 8:39Speaker 01

  Depression, anxiety, substance use, eating disorders, psychotic disorders, they're all going up. And, you know, right now, most people are kind of skeptical of all of that. And I think the skepticism falls into a few different categories. So some people will say, it's because we're just recognizing it more. Everybody's talking about mental health. Everybody's

• 9:05Dr. Darshan Shah?

  I hear that a lot.

• 9:06Speaker 01

  Coming out of the woodwork, talking about their symptoms, and we're just recognizing it. And so we're accurately diagnosing these disorders that have clearly been there all along. Others will say, this can't possibly be true. This is nonsense. Everybody's whiny and lazy and everybody wants a diagnosis. Everybody wants to be special. They all want pills because the pills are supposedly going to make you feel better. And who doesn't want an edge? So everybody wants pills. And although both of those things may have some truth in them, the reality is if you talk to the researchers doing this research, if you talk to emergency room doctors, if you talk to school teachers

• 9:49Speaker 01

  who've been teaching for more than 30 years, they are all unequivocal in their answers. The rates of mental disorders are skyrocketing and they are frustrated, alarmed, brokenhearted. What is happening to the people that we are seeing? Because they know, I wasn't missing this 30 years ago. Something is wrong in the world and we have a massive mental health epidemic.

• 10:21Dr. Darshan Shah?

  Yeah. So I struggle with this myself in not just mental health, but also physiological health. Because I feel like, you know, we're about the same age. We saw this train wreck happening throughout the course of our lives. And I do, I'm a huge history buff, so I kind of read a lot about what was life like before I was born? Maybe 1920s, 30s, 40s. This was not an issue back then. There were mental wards and then those mental wards kind of emptied out with the advent of some of the medications that were invented probably in the post-World War II area, era. But then something switched in post-World War II, America and the world,

• 11:04Dr. Darshan Shah?

  where obesity rates, diabetes rates, autoimmune rates, all just started skyrocketing. And mental health disorders, as you just said, was part of that. History. And so what do you think it was that kind of sparked this fire?

• 11:21Speaker 01

  You know, that is, so most people don't even realize that those things are related that you just said. They don't understand that. They're like, what are you talking about? Obesity and diabetes have nothing to do with mental health. But as I think you know, I believe they are very much related. And that obesity is a sign or symptom of metabolic dysfunction. Diabetes is a symptom or sign of metabolic dysfunction. And mental illness is too, but it just is specific to the brain. And, you know, the first thing that some people have trouble getting over is the obesity thing. Because not all people with

• 12:06Speaker 01

  mental illness are obese or overweight. Some are actually emaciated. They're thin. They have anorexia nervosa. Or they're alcoholics. They're drinking themselves to death. They're homeless. And they're emaciated on the street. And they clearly have a mental disorder. So you can have metabolic dysfunction in your brain and be thin. You can have metabolic dysfunction in your brain and be normal weight. You can have metabolic dysfunction in your brain and be overweight or obese. So metabolic dysfunction doesn't equate with obesity, yet. The fact that the rates of obesity are skyrocketing tells us that the rates of metabolic dysfunction are skyrocketing. And it is not a coincidence that the brain

• 12:50Speaker 01

  is being impacted. The question of what causes it, the reality is, you know, rates of those things were even increasing prior to World War II. Because Hitler, for example, was consumed with this scourge, the skyrocketing rates of this thing called cancer, which is also related to all of this. It's related to obesity and diabetes. And although the rates back then pale in comparison to what they are now, as societies have westernized across the board, this is for centuries, as societies westernize, we get these diseases

• 13:35Speaker 01

  of affluence. And the diseases of affluence largely are obesity, diabetes, cardiovascular disease. And oh, by the way, as a side note, mental health conditions and that as society's westernized, that's what happens. And so there's clearly something about westernization that is driving disease in humans, this broad range of diseases. There's no doubt in my mind that ultra-processed foods are playing a large role in this. And the processing of foods and what we're consuming really began around the time that

• 14:19Speaker 01

  you described in the 1950s or so, that we really started, and everybody thought it was just a miracle breakthrough.

• 14:28Dr. Darshan Shah?

  Yeah.

• 14:29Speaker 01

  That we have these shelf-stable, long-lasting foods that can be packaged in plastic and last for months on a shelf.

• 14:39Dr. Darshan Shah?

  Right.

• 14:40Speaker 01

  And stay fresh and no bacteria, no mold, no nothing. And we thought that this was great. It turns out, maybe it's not so great, and we can get into that. But at the same time, westernization is also associated with environmental toxins.

• 14:54Dr. Darshan Shah?

  Right.

• 14:55Speaker 01

  As factories come in, you get air pollution, and more importantly, you get contamination of the water. So these factories, back in the old days, were producing all sorts of harmful chemicals, many that are banned now, that we now know, oh, those were actually poison. Well, what were those factories doing with those chemicals after they were done with them?

• 15:18Dr. Darshan Shah?

  Dumping them in the water.

• 15:19Speaker 01

  Put it right in the river. Why not? Why not?

• 15:22Dr. Darshan Shah?

  Why not?

• 15:22Speaker 01

  That's an easy way to dispose of those things. And of course, that then gets into the well water, that gets into the water system for the, you know, the city.

• 15:35Dr. Darshan Shah?

  Animals and farms.

• 15:36Speaker 01

  The town. Yeah. So every, and so I think in my mind, those are kind of the two most likely culprits. Food supply and environmental toxins.

• 15:49Dr. Darshan Shah?

  Right. I would probably add to that also that That was around the time period as well that people became more sedentary. The modern comforts of life helped us to spend more time not moving. And also probably some element of having more shift work and staying up late at night with the light bulb and television. All these little factors kind of additively. You're right, you're the ultra processing of food and environmental toxins definitely are the top of the list, but I feel like movement and sleep are also probably contributory.

• 16:27Speaker 01

  A hundred percent. And then I'll add maybe one or two more to round it out. And then, and then I actually will stop. Yeah. Cause this is actually, these are the core principles of lifestyle medicine.

• 16:36Dr. Darshan Shah?

  Exactly.

• 16:37Speaker 01

  The other thing that happens with, with kind of westernization is that you get large cities and people are forced to live closer and closer to each other. You get increased levels of stress from that. You, more importantly, probably you get societal hierarchies. You have poor people, working class, and you have rich people. And those societal hierarchies end up having effects on the poor people. The rich people are doing fine, but the poor people are not doing fine in that equation. And you get more crime as a result and the rich people are impacted by that.

• 17:20Speaker 01

  When you have a lot of poor people, all densely kind of.

• 17:25Dr. Darshan Shah?

  Packed in there.

• 17:25Speaker 01

  Packed in there. You, you're gonna get more crime, more violence, more other things. So if you imagine kind of a nice little farming village community where everybody's got their own little plot of land, some might be richer than others, but the range is not nearly as wide as it is in a city. And for the most part, in those little farming villages. Everyone's in a community, like even, even the people who are a little odd, or maybe not as bright, or maybe not as hardworking, or whatever, they're still part of the community.

• 18:01Dr. Darshan Shah?

  Sure.

• 18:02Speaker 01

  They're not ostracized, they're not neglected, they're not ignored. They're still part of the system. And so people look out for each other, families stay together more often. And, and so that really talks about, you know, the six pillars of lifestyle medicine. We're talking about nutrition, sleep, exercise. We're talking about harmful substances. So usually lifestyle medicine is, talks about smoking, vaping, alcohol, but I'm going to include environmental toxins in that.

• 18:34Dr. Darshan Shah?

  You have to, right.

• 18:34Speaker 01

  Harmful substances. But then we also need to talk about stress reduction and relationships or purpose in life.

• 18:42Dr. Darshan Shah?

  Absolutely.

• 18:42Speaker 01

  And those are the buckets, those are the basic elements of human health.

• 18:47Dr. Darshan Shah?

  Yeah. And I feel like for you and I, this is intuitive now, right? Because we talk about this all the time. But when I went through medical school, I graduated in 95. I went through medical school. None of this was brought up in any of the textbooks about mental health disorders. I went through rotations in psychiatry. Never was anything in lifestyle brought up as part of what's causing someone to experience any of the symptoms that they're experiencing from any mental health disorder. And instead, what was done was we tried to figure out which mental health disorder they had and assign a name to it, and then find a pharmaceutical to treat that one. And like you said earlier, you just kept trying pharmaceuticals until you found one that kind of worked, you know?

• 19:32Dr. Darshan Shah?

  And that's, I started this conversation telling you that, you know, I just felt like it was somewhat futile and hopeless because it took a long time and many people never got better. Some people actually got worse. Then you're doubling, tripling up medications. And this is how we addressed mental health for decades. And I feel like, I feel like this is kind of still happening right now.

• 19:53Speaker 01

  It's 100% still happening. Nothing's changed. What, what you just described is the state of the art.

• 19:59Dr. Darshan Shah?

  Yeah.

• 20:00Speaker 01

  In the mental health field. The, and in fairness, I'll say that- There are feuds within the mental health field that have persisted for decades. Between people, many mental health professionals, including psychiatrists, hate that model. And so they instead focus on the psychological and social causes of mental illness. And they think psychotherapy is the treatment of choice. So let's not poison people with these pills. Let's not medicate them. Let's just lay them on a couch, or sit them in a chair, or have them do exposure therapies, or write down CBT worksheets. But they basically are saying, if we can just get to the psychological and social root

• 20:43Speaker 01

  causes, we will solve the problem. And, you know, there are, there are people who have such myopic, polarizing views on all of this. That, you know, the, the really good mental health clinicians understand that both of those things can be true. Some people can benefit from medications, and other people can benefit from psychotherapy, or maybe the combination is ideal. Those are actually the enlightened mental health professionals today.

• 21:14Dr. Darshan Shah?

  Right.

• 21:15Speaker 01

  And with that, you still, if you go to a mental health ward, you still see this very bleak, dire situation.

• 21:25Dr. Darshan Shah?

  Yeah.

• 21:26Speaker 01

  Of lives ruined.

• 21:28Dr. Darshan Shah?

  Right.

• 21:28Speaker 01

  People are getting that. People are getting those pills. People are getting psychotherapy. I know so many people who've lost loved ones. Some vocal advocates, they're running nonprofit organizations focused on, we need to improve mental health care. And sometimes they kind of are really focused on, we just need better access to care. We need insurance companies to start paying for mental health care. And make no mistake, I am 100% for that. Yes, we do.

• 22:01Dr. Darshan Shah?

  Sure.

• 22:02Speaker 01

  But then I've asked those same people, well, did your loved one who's dead by suicide, did your loved one not get mental health care? And what they say, almost across the board, is, oh, no. He got the best care available. We spared no expense. We spent hundreds of thousands of dollars on his mental health care. And he's dead.

• 22:28Speaker 01

  And I say to them, so do you really think helping people get access to ineffective mental health care is going to solve the problem? And they're usually just speechless when I have the audacity.

• 22:42Dr. Darshan Shah?

  Yeah, how do you answer that?

• 22:43Speaker 01

  They're usually just speechless when I have the audacity to say that, especially as a psychiatrist, because I'm supposed to be championing mental health treatments. But I do this, I do this not as an assault on mental health professionals. I guess I should say that and make that clear. In my heart of hearts, I actually believe most mental health professionals are actually extraordinarily kind, compassionate human beings.

• 23:12Dr. Darshan Shah?

  Absolutely.

• 23:13Speaker 01

  Who desperately want to help.

• 23:14Dr. Darshan Shah?

  Right.

• 23:15Speaker 01

  And they are doing everything they've been taught to do, and they are trying their hardest. And what I'm here to say is that there is a better way, based on science, that we can actually give those clinicians better treatment tools. We can help them understand some of the harms that they might be inducing on patients with some prescription medications. Even though we were taught to do that, I was taught to do it too. I now recognize that when we impair people's metabolic health or physical health with the very pills that we are prescribing, we may in fact be making patients chronic patients.

• 23:58Speaker 01

  We may be impairing their ability to heal and recover.

• 24:01Dr. Darshan Shah?

  Right, absolutely. And so I look at your message, and it's really trying to add this third leg of the stool to how we think about mental health care. We have therapy, we have these pharmaceuticals, but what you're saying is really focusing and maybe even making the primary treatment modality a focus on metabolic health in the lifestyle medicine that we talked about, making that part of the treatment algorithm for almost everybody, for everybody, pretty much. And I'm wondering, when you, I mean, you're such a renowned speaker, but when you tell other mental health professionals this idea, what is the reception to that?

• 24:40Speaker 01

  You know, there's a range.

• 24:42Dr. Darshan Shah?

  Okay.

• 24:43Speaker 01

  For the most part, it really depends on how much time I have with them.

• 24:48Dr. Darshan Shah?

  Yeah.

• 24:49Speaker 01

  It honestly does. Right. If I have, if I have more than 15 minutes to walk them through what I want them to understand, more than 80, 90% are at least intrigued and/or interested in learning more. And it's because I can meet them where they're at. I can say, I know the bio psychosocial model. We know that. We share that in common. But how does it fit together? How does it cause brain dysfunction that we call mental illness? And how do we distinguish normal human suffering from brain dysfunction? Because they're not the same thing.

• 25:31Speaker 01

  If the love of your life dumps you or betrays you and cheats on you, you will be depressed. And if you're not depressed, you either didn't really love the person or there's something seriously wrong with you. So if you are normal and healthy and the love of your life dumps you, you will be depressed. And guess what DSM-5 TR? It will be longer than two weeks. It will not just last two weeks and then go away. Normal, healthy people will be devastated for longer than that. Absolutely. And I don't believe that that is brain dysfunction. No, right. That's normal course of life. That is normal human suffering.

• 26:16Speaker 01

  Just like if you get cut and have pain or if you break a bone and you have pain for a month afterward. That is not a pain disorder. You're experiencing pain. You're suffering, but it's understandable. And we can still deliver treatments. We can still help people in a compassionate way. I'm not at all trying to say we, those people don't need help. Of course they need help. But we understand the help they need. The help is, let's keep them safe. Let's keep them alive. Let's talk to them. Let's help them figure out, how are you gonna move on? What could your life look like without this person? How, you know, at some point when they're ready, how could you find another person if that's really important to you?

• 27:01Speaker 01

  And those are common sense treatments and tools. But there is another category of people who have brain disorders.

• 27:09Dr. Darshan Shah?

  Oh, yes.

• 27:10Speaker 01

  And I believe that those people, when you do a deep dive into all of the science that we've accumulated, whether it's brain imaging, genetic studies, looking at what are all these risk genes for schizophrenia and bipolar and epilepsy doing? Whether it's trauma. How does trauma cause brain dysfunction? How does that work? When you put it all together, the soundbite is, it is metabolic dysfunction affecting the brain.

• 27:40Dr. Darshan Shah?

  Can trauma lead to metabolic dysfunction? I know metabolic dysfunction can definitely put you at risk for traumatic events causing brain disorder, right? However, does it work the opposite way as well? Where a traumatic event can actually increase the effects of metabolic disorder in your brain?

• 27:59Speaker 01

  100%. And traumatic events can actually be the primary root cause or the primary insult that leads to it.

• 28:10Dr. Darshan Shah?

  Wow.

• 28:11Speaker 01

  And so, we know that. So again, I'm gonna start with a science thing and then I'm gonna come to some common sense observations.

• 28:18Dr. Darshan Shah?

  Please, yes.

• 28:19Speaker 01

  So the science version is that there are researchers who have been looking at this for decades.

• 28:23Dr. Darshan Shah?

  Okay.

• 28:24Speaker 01

  And they've been trying to figure out. They've been focused on cortisol and genetics and epigenetics and stress response, all sorts of things. And many of those researchers are now zeroing in on mitochondrial dysfunction as the way to understand all of it. And for people who don't understand that, it doesn't mean that cortisol is not related. It turns out that mitochondria actually control the first step in the synthesis of cortisol. So if you- You're wondering, how would cortisol dysregulation happen? You have to implicate mitochondria in that process. So the, the science is all converging at the level of mitochondria,

• 29:07Speaker 01

  which is really metabolic in many ways. Metabolism is more than mitochondria, but it, Yes. You know, mitochondria are like the master regulators of metabolism. Right. So there's a tremendous amount of science. There are some leading researchers, chair people of departments of psychiatry, prestigious, you know, universities, who are all working in that way. The common sense kind of observations to support what I just said is that we know that, you know, probably the best evidence that we have on trauma, it's called, you know, adverse childhood experiences studies, the ACEs. And people who have more ACEs are more likely

• 29:50Speaker 01

  to have both mental health and metabolic disorders. People who have high numbers of ACEs are more likely to have, really depending on when those adverse childhood experiences occur, pretty much every mental disorder. If it occurs early enough, it increases your risk for all of the neurodevelopmental disorders. Right. Autism, just look at the Romanian orphan story to understand the massive rates of autism. Right. When you are severely neglected. Right. That's not genetic. No. Those weren't, those babies weren't born with genetic defects. They were just severely neglected. Right. And that resulted in what we call autism or learning disorders or ADHD.

• 30:33Speaker 01

  But then all the way up to post-traumatic stress disorder, depression, anxiety, personality disorders, eating disorders, substance use disorders, all of them. And then in older age, higher rates of dementia. Right. So essentially, everything listed in DSM. Right. Can occur from trauma or adverse childhood experiences. At the same time, Those people are also much more likely to develop all the metabolic disorders. They're more likely to have obesity, type 2 diabetes, cardiovascular disease, and they're more likely to die early deaths. One meta-analysis recently looked at people who have six or more aces compared to people who have no aces. On average, they lose 20 years of life.

• 31:17Dr. Darshan Shah?

  Wow.

• 31:17Speaker 01

  Six aces cause you to lose 20 years of life.

• 31:22Dr. Darshan Shah?

  Wow.

• 31:23Speaker 01

  And what are they dying of? Cardiovascular disease, diabetes, obesity, mental health disorders, all of those things.

• 31:28Dr. Darshan Shah?

  Yeah. I mean, there's such a powerful statement about just how we raise our children as well in setting them up for risk of mental health issues and metabolic issues like obesity, diabetes as well. But you know, the flip side of that that I think about is I know many well-intentioned, really good parents that will do anything for their children. And children are still suffering at a much higher rate of autism for those parents as well. So why, how do you reconcile that in people's mind? Like, how are kids getting autism at a much higher frequency even without any aces?

• 32:08Speaker 01

  So that's the thing. We have to put it all together.

• 32:11Dr. Darshan Shah?

  Right.

• 32:12Speaker 01

  It's biological, psychological, and social. So the psychological, social includes that trauma piece.

• 32:18Dr. Darshan Shah?

  Right.

• 32:19Speaker 01

  So that can be a big part of the equation for some people. But I am by no means arguing that the rate of trauma and abuse have gone up in the population.

• 32:30Dr. Darshan Shah?

  For sure.

• 32:30Speaker 01

  There is no reason to believe that. If anything, we are a safer society. Women are less likely to be assaulted today than they were 20 years ago, than they were 50 years ago. Children are less likely to be assaulted today than they were decades ago. So. By no means am I arguing that. And instead, we need to look at what else is driving it. So the answer to your question, what could be driving it? We know that parents who have metabolic dysfunction are more likely to have children with neurodevelopmental disorders.

• 33:12Speaker 01

  And that includes autism and ADHD. And so we see skyrocketing rates of both autism and ADHD. And people are scratching their heads like, this can't possibly be true. Maybe we're just recognizing it more. We're over diagnosing it. Everybody just wants to be autistic nowadays. It's a trendy label. Everybody wants to be autistic. What I'm here to say is, no, no, folks.

• 33:38Dr. Darshan Shah?

  No.

• 33:39Speaker 01

  No, that's not the bulk of the explanation. Can you find some examples of all of that? Sure. I'm not here to say that those are 100% false. They can happen. But if the rates of obesity and diabetes are skyrocketing, so too will the rates of autism and ADHD and other neurodevelopmental disorders. And the alarming thing is even though people are like, well, I know somebody who was thin and had an autistic child. Yep, I do too. I am not here to say that obesity is the sole, only risk factor for autism. By no means. Infections can play a role. Hormones can play a role.

• 34:20Speaker 01

  All sorts of environmental things, biological things. And yes, genetics, epigenetics can play a role. There's no doubt about that. But let's put it all together. Let's not put our heads in the sand and pretend that the rates aren't increasing. And more importantly, let's help these people.

• 34:42Speaker 01

  Heal and recover. You know, the, the topic of autism is always challenging because people are born that way.

• 34:51Dr. Darshan Shah?

  Right.

• 34:52Speaker 01

  Or develop that way early in life. They didn't do anything wrong.

• 34:56Dr. Darshan Shah?

  Right.

• 34:57Speaker 01

  And sometimes when they hear me talk, they feel like I'm attacking them or saying that they shouldn't exist, or saying that, that we should euthanize them, or like, and I'm not at all arguing that. But, but for people who don't know this, people with autism are much, much, much more likely to suffer from a wide range of neuropsychiatric disorders. About 20 to 33% will have seizures. Most, about half will have ADHD. About half or more will have depression and anxiety.

• 35:38Speaker 01

  10% of people with autism, one in 10 will go on to develop schizophrenia on top of their autism.

• 35:47Dr. Darshan Shah?

  Wow.

• 35:47Speaker 01

  So when people hear me talk about this and say that we need to do something about it, I'm not here arguing that humans shouldn't exist, or that we can't accept people who are neurodiverse, or that we can't make room in our society for these people who were born this way. Of course, we need to make room in society for them.

• 36:08Dr. Darshan Shah?

  Sure.

• 36:08Speaker 01

  But they are much more likely to have these debilitating, chronic, comorbid, awful, sometimes life-threatening conditions, and we need to help them. And in order to do something about it, both in terms of treatment and prevention strategies, we need to understand what is driving all of this. And that means we need to put it all together.

• 36:31Dr. Darshan Shah?

  Right.

• 36:31Speaker 01

  In a more sophisticated, network-based, systemic-based way.

• 36:37Dr. Darshan Shah?

  Right.

• 36:38Speaker 01

  That largely the functional medicine community has been doing for decades, saying, there's a cause for this, and let's put it together and figure it out.

• 36:49Dr. Darshan Shah?

  You know, I see, I have a friend with two autistic children and both of them do so much better when their metabolic health is addressed and they're fed the right foods and they are allowed to sleep and they're allowed to breathe clean air, et cetera. All these things, to your point, you know, I think people who suffer from some level of autism, autism spectrum, they are better when their metabolic health is on point. And so it's even more important to use all the techniques and lifestyle of functional medicine, whatever you want to call it, on those people.

• 37:26Speaker 01

  100%. Again, we want to, I mean, one of the things that I'm sometimes asked is, can you, so, Dr. Palmer, can you cure autism? And I want to be clear, for the most part, I don't think there is a cure for autism later in life. And the reason for that is this, that humans go through neurodevelopmental windows during which we acquire different skills, language skills, social skills, the ability to walk, the ability to balance ourselves, all sorts of things. But they occur in these developmental windows.

• 38:06Speaker 01

  And if you get through that window and don't acquire the skills, or you get through that window and you just acquire certain skills but not all of them, it is, it can be very difficult, if not impossible, to go back in time and redo it. And so I think that when people have gone through neurodevelopment, more than likely the social skills, the learning abilities and styles are going to be there. It doesn't mean that we, if somebody is quote unquote neurodivergent or different, that we can't help them thrive. We can, just so, just like somebody may have a learning disorder. That doesn't mean the person can't learn. It just means they learn in a different way.

• 38:50Speaker 01

  It might mean they have trouble reading. So maybe we should use auditory information for them or come up with more engaging ways to help them learn the material. And same with social skills. That if they haven't learned social skills in the same ways that most others have, or they haven't acquired those social skills, it's OK. We can still help them thrive in society. But at the same time, as you pointed out, they have a lot of comorbidities and they have a lot of other challenges. And those other comorbidities and challenges are very amenable to improvement with metabolic enhancing kind of treatments.

• 39:33Dr. Darshan Shah?

  Yes.

• 39:37Dr. Darshan Shah?

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• 40:16Dr. Darshan Shah?

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• 40:56Dr. Darshan Shah?

  Let's go back to the science a little bit because I want to make sure people really understand the science that you're discussing. And I think it's important to recognize one quick fact, and I say this almost every single day. Metabolic disease and obesity, yes, they're related, but you don't have to be obese to have metabolic disease. Metabolic disease, obesity is one, I would say, sign of metabolic disease in some people, but not everybody. And so I would love for you to walk the listeners through, what is metabolic disease? And specifically, how is that leading to brain impairment?

• 41:33Speaker 01

  So, you know, the, the reality is metabolism, in some ways, is almost synonymous with all of biology.

• 41:43Dr. Darshan Shah?

  Right.

• 41:44Speaker 01

  The study of living organisms. And why do I say that? Because part of the foundational definition of a living organism is the ability to do metabolism independently. And if you're a living, if you're an organism, like a virus, that cannot do metabolism on your own, many biological authorities don't consider that a living organism. And so what is metabolism? It's the ability to take food, oxygen, key nutrients from the environment, and turn those into an energy source, ATP, or building blocks used to maintain or grow cells.

• 42:27Speaker 01

  And then that whole process leads to some waste products, and you have to be able to efficiently manage those waste products. Like, if those waste products build up, organisms can die. So it's really those three things. Taking food, turning it into energy, building blocks, and managing the waste products from those processes. And so, in a way, a metabolic problem means a problem with that.

• 42:54Speaker 01

  And where could that problem reside? Actually, there are numerous enzymes and hormones and neurotransmitters and all sorts of things that are playing a role in that process. But if you really study the field, they almost all converge at these tiny little organelles in our cells called mitochondria. And it turns out that my, you know, most people who know mitochondria usually know the phrase powerhouse of the cell. And what that means is that they are taking food and turning it into ATP. And ATP is the power source for cells, so they are the powerhouses. And some people, most people probably don't even think about them, but there are researchers

• 43:39Speaker 01

  who even think that mitochondria are nothing more than just little power packs or batteries, that they're just these little batteries that kind of are in the cell and they're just churning out some ATP and that's all they do. And they're kind of just stupid little organelles, not doing much more than that. The reality is that research over the last 30 years has completely shattered that simplistic view of mitochondria and that mitochondria are actually, you know, were once independent living organisms that became symbiotic with an archaea. And that resulted in basically all eukaryotic life that we can see with our eyes today.

• 44:21Speaker 01

  And so it's important to just respect and honor that. This used to be a living, an independent living organism, a bacterium. And that, but within a cell, mitochondria are actually a whole community. There are hundreds or thousands of them in a cell and they're moving around and they fuse with each other and they break off from each other. And they are playing foundational roles. And so to help people understand how it could result in mental illness, they play a role in the production and regulation and release of neurotransmitters like GABA, glutamate, dopamine. They play a role in turning inflammation on and off.

• 45:06Speaker 01

  They play a role in the stress response, the psychological stress response, cortisol, adrenaline, inflammation. They're playing a role in that. They're playing a role in epigenetic regulation of genes from the cell nucleus and just countless other things. And so when you put it all together, when they become dysfunctional, then that can result in dysfunction of the way the cells, dysfunction of the cells, meaning the cells aren't functioning properly. And at the end of the day, the mental disorders that I'm talking about, when the brain isn't working right, that's really the definition of it.

• 45:48Dr. Darshan Shah?

  Right.

• 45:49Speaker 01

  Cells aren't working properly.

• 45:51Dr. Darshan Shah?

  Right.

• 45:51Speaker 01

  And the hopeful news, although the science is complex and the metabolic pathways get overwhelmingly complex, and there are many of them we probably don't even know about.

• 46:03Dr. Darshan Shah?

  Know about, right.

• 46:03Speaker 01

  At the end of the day, the most hopeful piece of this is that those basic lifestyle things that we talked about are foundational to mitochondrial function, to metabolic health, and that we can use those tools to actually help people heal and recover.

• 46:23Dr. Darshan Shah?

  Yes, absolutely. And I think that's such a key message because if any listener out there is suffering from depression or maybe you even have bipolar disorder, anxiety, getting your metabolic health right should be one of the things that you're doing at the same time as seeking mental health services. And so I always look at this, you know, I see a lot of patients here at the clinic. I see clinic patients twice a week. And I would say it's almost 100% of people, I would say now, have some level of either anxiety, depression.

• 46:56Dr. Darshan Shah?

  Bipolar disorder, unmitigated stress in their life. And once we start getting their metabolic health in order, some of those problems actually melt away completely. I mean, it's miraculous how it's so interrelated. And so to think that the brain is doing its own thing that's separate from the rest of the body and not really suffering from a disordered metabolism is just completely wrong. It's wrong thinking. It's all interrelated.

• 47:26Speaker 01

  It is.

• 47:26Dr. Darshan Shah?

  Yeah.

• 47:27Speaker 01

  And I just want to kind of just bolster that a little bit.

• 47:33Dr. Darshan Shah?

  Please.

• 47:33Speaker 01

  Because the way you said it is so obvious. And yet, 99% of people, if they go to a mental health professional right now and say, I've been diagnosed with ADHD or bipolar or schizophrenia or chronic unrelenting depression or post-traumatic stress disorder or alcoholism. Do you think that what I eat could be playing a role in that? Most of those people will be told unequivocally, no.

• 48:05Dr. Darshan Shah?

  Right.

• 48:06Speaker 01

  No. What you eat has nothing to do with those serious, severe brain conditions. Those are brain conditions. Those are chemical imbalances. Or those are from trauma. Or that's from addiction. The addiction pathways in the brain, dopamine. That has nothing to do with the food that you eat. So that is actually the state of the art right now. That's where we're at as a field.

• 48:36Dr. Darshan Shah?

  Right.

• 48:37Speaker 01

  Is people will just, they're unaware. They deny it. They, they, they don't get it. They don't understand the science. And yet, here's the way I usually can hook people. What you eat can play a role in whether you have a heart attack or not. Believe it or not, that's a life-threatening condition. It can take your life. More people die from that than anything else, actually.

• 49:01Dr. Darshan Shah?

  Exactly.

• 49:01Speaker 01

  That's severe, isn't it? Isn't that serious? That's kind of serious. Heart attack. But what else can a bad diet do? Can cause you to have obesity, which can increase your risk or contribute to liver disease, kidney disease, gonad disease, infertility, autoimmune disorders, joint disorders, eye problems, hearing problems. So what you eat and the metabolic dysfunction that results can affect all of these other organs and tissues in the body. And somehow people think the brain is immune?

• 49:42Speaker 01

  It's ridiculous. It's outlandish. And when I say it that way, even these skeptical psychiatrists are kind of like speechless, like, well, I, uh, uh, nobody really put it that way before. I don't know what, I don't know how to defend myself now. I know that diet doesn't play a role in it, but when you put it that way, uh, is the brain immune? I don't know. And, and what I'm here to say is, no, the brain isn't immune. The brain is actually the most sensitive organ to metabolic dysfunction. And what are the signs or symptoms of metabolic dysfunction? Look in DSM and you'll see them.

• 50:24Dr. Darshan Shah?

  There's hundreds of them. Let's sit in there. The DSM for listeners is our book of diagnoses of mental health conditions. And there's how many, how many mental health conditions in there?

• 50:33Speaker 01

  Dozens and dozens. It depends on whether you take the subcategories or not, but well over 70 kind of. And some would argue even more.

• 50:42Dr. Darshan Shah?

  And what's really powerful about this is that what we're saying here is that whether you're listening to this episode and you have anxiety, or you have bipolar disorder, or you have depression, whatever it might be, this is a root cause of all of it. So if you could get your metabolic milieu in your mitochondria and your cells correct, all of those will get better in some way or the other. Or at least even if you're on medication, you might be able to reduce your dose or get on less meds if you have polypharmacy going on. All of it can be helped by this root cause, right?

• 51:19Speaker 01

  I agree. And you know, I think whether we call it root cause or whether we call it common pathway might matter. And I actually probably would prefer the term common pathway. And then if you ask the question, well, what can cause that? What can cause mitochondrial dysfunction? That's where we come back to something that the mental health field already knows and accepts as fact, biological, psychological, and social factors. So biopsychosocial. But this is where I think we need to lean heavily more on the functional medicine community and begin to integrate what we call functional medicine with metabolic medicine,

• 52:02Speaker 01

  metabolic health with chronic disease management. And those need to become one in the same. That we need to stop with these arbitrary categories of what kind of healthcare do you practice? How about just human healthcare? And helping people heal and recover. But we need to put that together because again, most of the functional medicine community, it's focused on root causes. And they can be hormones, or environmental toxins, or diet nutrition, or lack of sleep. But those are driving this metabolic dysregulation or metabolic dysfunction.

• 52:41Dr. Darshan Shah?

  Yeah, Dr. Palmer, it's so funny you say it that way because. Whenever someone asks me, what kind of doctor are you now? I used to be a surgeon. Now they ask you, what kind of doctor are you now? Are you a longevity doctor? Are you a functional medicine doctor? Are you a preventative medicine doctor? What are you, what are you doing? Like, yes, all of it. It's all human medicine that we're practicing. And it has, some of its teachings are in functional medicine, yes, but some of it's even in just preventative medicine and Western medicine, all brought together. And it will impact your longevity as well. And so it's all together in human medicine.

• 53:13Speaker 01

  You're, you're a doctor.

• 53:15Dr. Darshan Shah?

  Right, exactly.

• 53:17Speaker 01

  You're a quote, doctor, unquote.

• 53:21Speaker 01

  Maybe, maybe we should put good doctor. Because that's what good doctors should do.

• 53:26Dr. Darshan Shah?

  Yeah.

• 53:27Speaker 01

  Good doctors should not just ask you about symptoms, give you a label, whether that label is depression or high blood pressure or diabetes, and call it a day and just prescribe a medicine. That's actually not good doctoring, in my mind.

• 53:44Dr. Darshan Shah?

  Yeah, and you know, unfortunately, medical education went this way, back with the Flexner report. And every, and medicine became siloed into all these different branches, cardiology and mental health and I did surgery. And you know, we have Western medicine for a reason. It's great if you get diagnosed with cancer, or you get hit by a bus, or you have a heart attack. Thank God we have Western medicine. But really, the way it was built was not meant to take care of the human as a whole. It's, it's turned into this siloed, disease diagnosis, here's a pill for every ill, kind of a world. And getting back to this type of medicine, I think, is what you're, what you're advocating and what I advocate for.

• 54:25Speaker 01

  A hundred percent. And increasingly, it's really kind of tragic because, you know, the, I think there are a lot of family practice docs, if any of them are listening, they're like, hey, this is what I do. This is what I went into medicine to do, is to be a holistic.

• 54:42Dr. Darshan Shah?

  Right.

• 54:42Speaker 01

  Everything kind of a doctor. And even just primary care docs, who trained in internal medicine. Increasingly, primary care is a dying field, is what we're increasingly learning.

• 54:56Dr. Darshan Shah?

  Right.

• 54:56Speaker 01

  That there are fewer and fewer of them. They are overstretched. There are more and more demands on them to not be a holistic doctor, but instead, dole out pills for all of these ills.

• 55:09Dr. Darshan Shah?

  Yeah.

• 55:10Speaker 01

  And just make sure you dole out enough pills. And, you know, the reality is, if that model worked, I would be all for it.

• 55:20Dr. Darshan Shah?

  Absolutely.

• 55:21Speaker 01

  It would be so much easier, wouldn't it, to just, you know, oh, here's a label that you've got, here's a pill for it.

• 55:27Dr. Darshan Shah?

  Right.

• 55:28Speaker 01

  All set, you're gonna, you're gonna live happily ever after. You know, when people have chronic diseases, some people don't get too upset about them. Obesity, you know, there's a growing movement that the solution to the obesity epidemic is body positivity.

• 55:46Dr. Darshan Shah?

  Yeah, to accept it.

• 55:47Speaker 01

  We just need to accept that people will be overweight or obese, and that beauty can come in all shapes and sizes. And if we would just accept people's obesity and love them for who they are, the world would be a better place. And there are people with obesity who are doing otherwise very, very well. But if you look at the actual statistics, people with obesity are much more likely to develop all of these other metabolic health conditions. So, high blood pressure, cardiovascular disease, premature mortality, cancer, autoimmune disorders, all these things. And, oh, guess what, the brain, oh, let's not forget the brain.

• 56:31Speaker 01

  Which mental health conditions, Dr. Palmer? Because everybody thinks, well, it's just, you know, maybe some depression because of all the fat shaming that's going on. Well, yes, they're more likely to be depressed, but they're also more likely to have anxiety disorders, psychotic disorders, bipolar disorders, schizophrenia, substance use disorders, eating disorders, personality disorders. They're anywhere from 50% to 350% more likely to have this broad range of mental health conditions. And so, the reason that I'm unwilling to accept the status quo, the reason that I'm fighting to change it, is because this system isn't working.

• 57:14Speaker 01

  And I, as a psychiatrist, am probably biased. I am seeing the people who are suffering, who are in mental anguish, and their lives, at a minimum, people are suffering and trying to do better.

• 57:33Speaker 01

  And sometimes people's lives are completely ruined and shattered by mental illness. And sometimes people's lives end by mental illness with an opioid overdose or a suicide. And so I'm seeing the people for whom this system is not working well at all. This is just completely insufficient and inadequate, and we can do better.

• 58:02Dr. Darshan Shah?

  Absolutely.

• 58:07Dr. Darshan Shah?

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• 59:06Dr. Darshan Shah?

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• 59:49Dr. Darshan Shah?

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• 59:59Dr. Darshan Shah?

  So a lot of people listening to this podcast are thinking, I have one of these diagnoses. Dr. Palmer, can you tell me, what are some of the things I can do to start addressing my metabolic health? What is, you mentioned diet a few times. Tell me a little bit more about the diet interventions that you recommend. Can you talk through some of the basics of your recommendations or your thought processes around improving metabolic health?

• 1:00:23Speaker 01

  I can. So I would say, you know, step one is just assessment. Which mental health symptoms are you having? It's helpful to at least know. Which metabolic health signs or symptoms do you have? Shockingly, 93% of American adults have one or more biomarkers of poor metabolic health.

• 1:00:46Dr. Darshan Shah?

  93%. I want to double click on that because that is, almost everybody has sub-degree of metabolic dysfunction.

• 1:00:53Speaker 01

  Yes.

• 1:00:54Dr. Darshan Shah?

  And it wasn't this way 80 years ago.

• 1:00:56Speaker 01

  No, it was not. No, it was not.

• 1:01:00Dr. Darshan Shah?

  And we know this.

• 1:01:01Speaker 01

  That is why this is so alarming. So it can be helpful to know what your blood pressure is, even if you think your blood pressure is completely unrelated to my anxiety or depression. What does that have to do with anything, Dr. Palmer? I'll take a blood pressure pill for it. No, no. A blood pressure pill will, yes, it will reduce your blood pressure, but it's not addressing the metabolic dysfunction that's causing your high blood pressure. And if you can figure out what's causing your high blood pressure and address it, you might improve your brain function at the same time. So I start with assessment, some basic assessments.

• 1:01:38Dr. Darshan Shah?

  Can I repeat what you just said? Because I think it's an important concept for people to understand. Just because you get a pill for high blood pressure, or you get a pill for high glucose levels, doesn't mean that you're addressing the metabolic dysfunction. It means that you are reducing a symptom of it. You still have to do the work to address the metabolic dysfunction.

• 1:01:59Speaker 01

  Yes, 100%.

• 1:02:00Dr. Darshan Shah?

  It's an important fact to recognize.

• 1:02:04Speaker 01

  And for people who may not, in case anybody doesn't kind of get that, let's say that you go out in a garden every day and you develop a rash.

• 1:02:16Speaker 01

  But you still keep going out and gardening every day because that's really important to you. But now, all of a sudden, you've just got a rash. And you put some hydrocortisone cream on your rash, and the hydrocortisone cream makes your rash go away for a while. But you keep going out to your garden because that's important to you. And this rash keeps growing, or spreading, or coming back. And pretty soon, you're rubbing cream all over your body.

• 1:02:40Dr. Darshan Shah?

  You're bathing in hydrocortisone.

• 1:02:42Speaker 01

  You have, you have, you have applied a symptomatic treatment, hydrocortisone cream, but you have not identified the cause. And the cause might just be poison ivy in your garden. And just take the poison ivy out and stop rubbing against it, and you've solved your problem. Now, that's so obvious. And yet, when people have high blood pressure, a pill is like hydrocortisone cream. Yes, it can reduce the symptom. But you haven't identified what caused your high blood pressure in the first place. And so, the, the basics of a metabolic treatment plan, the, the concrete basics really are the concrete basics of lifestyle medicine.

• 1:03:23Speaker 01

  So, diet, nutrition, sleep, exercise, movement, stress reduction, purpose, relationships, and managing harmful substances. So, I'm going to assume most of your listeners know what a lot of those basics mean.

• 1:03:38Dr. Darshan Shah?

  Yes.

• 1:03:38Speaker 01

  Harmful substances include, I'm going to go ahead and say this, because some of your listeners probably don't know this, harmful substances include marijuana. I'm sorry to rain on your parade, everyone. Marijuana is not good for your metabolism. It's not good for your mitochondria. It's not good for your brain.

• 1:03:55Dr. Darshan Shah?

  Well, what about CBD, Dr. Palmer?

• 1:03:57Speaker 01

  They definitely help people to relax.

• 1:04:00Dr. Darshan Shah?

  Yes.

• 1:04:01Speaker 01

  And so, CBD actually is more controversial. And the, the controversy comes from this, that when you have cells that are metabolically impaired, or dysfunctional, they can actually become hyperexcitable, and they actually can cause an inflammatory reaction. And so, some medicines, some substances can reduce hyperexcitability by actually impairing metabolism. That's how a lot of psychiatric medications are probably actually working, like antipsychotics. Now, you're further impairing metabolism, but you're addressing one of the symptoms of it. And I think CBD can do that.

• 1:04:43Speaker 01

  CBD, in some studies, not all, has been found to be possibly anti-inflammatory. So I'm more open-minded to CBD, but I'm still worried about CBD. There's no doubt THC, although it can help people feel more calm and relaxed in the moment, is actually harmful long-term to brain health. Just like alcohol. Alcohol is great in the short run. If you're out at a party and having a little social anxiety, a drink or two might calm that social anxiety. But if you do that every day, you're not helping your brain at all. So minimizing substance use. Vaping is like, everybody's vaping now, the kids are.

• 1:05:28Speaker 01

  So unfortunately, I'm here to rain on everyone's parade. I want you to all be boring and healthy and clean, sober, whatever you want. Like however we want to do it. Does everybody have to give everything up? No. Can some people get away with some of that? Especially occasionally, of course. But you're gonna have to weigh the pros and cons for yourself. And you're gonna have to assess your level of impairment and what level of risk you're willing to take. Movement.

• 1:05:58Dr. Darshan Shah?

  I'm so sorry to interrupt you, but I want to make sure we add to removing harmful substances. The harmful substances that are being dumped into our environment as well fall under that. We touched on this before, but how do you recommend people get some level of relief from the toxins in our air, food, water?

• 1:06:17Speaker 01

  I wish I had an easy answer for this one, honestly. I can give some simple answers. Some simple ones. I'm increasingly alarmed by the chemicals in plastics and microplastics. And, you know, recent studies have suggested that microplastics are being deposited into the human brain.

• 1:06:37Dr. Darshan Shah?

  I've seen that.

• 1:06:38Speaker 01

  And that the human brain actually has 10 times more microplastics than the kidney or liver cells do. And what that says to me not is that microplastics are making a beeline for the brain. What it says to me is that the brain can't get rid of them. That once they make it up to the brain, they're stuck there until they dissolve. And they dissolve into harmful chemicals that we don't want in our cells. So you really don't want that. The liver and kidney cells can die and they can get rid of microplastics in that, those ways. But the brain neurons don't, shouldn't be dying.

• 1:07:17Dr. Darshan Shah?

  Right.

• 1:07:18Speaker 01

  We get our neurons for life.

• 1:07:20Dr. Darshan Shah?

  Yes.

• 1:07:21Speaker 01

  And for the most part, there are a few exceptions to that rule and hippocampal neurons and some others, but for the most part, our brain cells are there with us for life. And if microplastics get into them, they're not going anywhere.

• 1:07:36Dr. Darshan Shah?

  There's just a pathology study where they took human brains and they melted them after death or did something where they were able to isolate the microplastics in the brain. And you could see decade after decade, the massive increase in them or microplastics that are isolated from human brains in the pathology lab.

• 1:07:56Speaker 01

  Yeah.

• 1:07:57Dr. Darshan Shah?

  It's crazy.

• 1:07:58Speaker 01

  Yeah. I'm actually potentially going to be doing more of that research at McLean Hospital and following up on some of that.

• 1:08:06Dr. Darshan Shah?

  Fantastic.

• 1:08:07Speaker 01

  Because it, that field is really in its infancy right now and we really don't fully understand what parts of the brain are more vulnerable, where are these microplastics accumulating? There are many unanswered questions right now.

• 1:08:18Dr. Darshan Shah?

  Yep.

• 1:08:18Speaker 01

  But I can safely say, microplastics don't belong in the human brain.

• 1:08:22Dr. Darshan Shah?

  Right.

• 1:08:23Speaker 01

  Let's just start with that.

• 1:08:24Dr. Darshan Shah?

  Right.

• 1:08:25Speaker 01

  And let's just say, there's reason to believe that they might be harmful to the human brain. Do I have 100% unequivocal proof of that? No, I don't. But let's, let's err on the side of caution and just assume that they don't belong there. That God, karma, didn't want us to have that there.

• 1:08:44Dr. Darshan Shah?

  Right.

• 1:08:45Speaker 01

  And that, and that maybe we should try to mitigate that. So, so how do we mitigate microplastic exposure? Try to reduce consuming food that is stored in plastic containers? So that's probably one strong way to do that. And the other is don't heat food in plastic containers. Now, I've got some really bad news on this. Like, I'm staying at a hotel, and what does the hotel do for coffee? They give you these little plastic pods. That you're supposed to have your coffee from. You're pouring hot water right through plastic. That's precisely what you're not supposed to do.

• 1:09:27Dr. Darshan Shah?

  I never thought of that, yes.

• 1:09:28Speaker 01

  You're pouring hot water through plastic.

• 1:09:31Dr. Darshan Shah?

  Wow.

• 1:09:32Speaker 01

  That means you are leaching microplastics into your hot coffee, if that's the way you prepare your coffee. So the better source of coffee is the old fashioned, you know, kind of...

• 1:09:47Dr. Darshan Shah?

  Brew it.

• 1:09:47Speaker 01

  Paper filter, and brew it, or...

• 1:09:51Dr. Darshan Shah?

  French press.

• 1:09:53Speaker 01

  French press, however you want to do it. Same with tea, same with other things. Avoiding, heating up food in plastic containers. This goes, you know, the, probably one of the more alarming things that I've just only recent, in the last few years, recognized. This applies to infants.

• 1:10:15Dr. Darshan Shah?

  For sure.

• 1:10:16Speaker 01

  In bottles.

• 1:10:17Dr. Darshan Shah?

  The bottles, right.

• 1:10:19Speaker 01

  So many really loving, kind, smart parents are putting formula or pumped breast milk painstakingly acquired.

• 1:10:32Speaker 01

  Pumped breast milk, they're storing it in a plastic container, putting it in a plastic bottle, heating it up in the microwave, and leaching microplastics into all of that. And that's probably not in your infant's best interest. So, yeah, unfortunately, it means we need to almost think about going back to glass or stainless steel or something else, some other. So if you use a water bottle, especially if you leave it in a hot car every now and then, get a stainless steel water bottle. Those can be some easy ways to reduce your exposures. The more you can get away from ultra-processed foods,

• 1:11:14Speaker 01

  the more you're going to get into diet, but the more you can get away from ultra-processed foods, the better. So one universal thing about ultra-processed foods is they're all wrapped in plastic.

• 1:11:23Dr. Darshan Shah?

  Yes, exactly.

• 1:11:24Speaker 01

  They're heated up at the factory, dumped into plastic, and sealed.

• 1:11:30Dr. Darshan Shah?

  Sealed with heat.

• 1:11:31Speaker 01

  Sealed with heat, probably. So, right there, you're getting a nice dose of microplastics in your ultra-processed foods. Who knows, you're getting all sorts of other things with that ultra-processed foods, all sorts of chemicals, other things. So, the more that you can eat real, whole food, so if you go to the perimeter of your grocery store, if you go look at the fresh produce section, it's not wrapped in plastic yet. You might put it in a plastic bag to take it home. I don't think that's detrimental necessarily. If you want to put it in something else, great. Unfortunately, grocery stores don't offer other things to put it in right now. But it's at least not being heated up. It hasn't been stored in a plastic bag. It hasn't been shipped across the world in a plastic bag.

• 1:12:15Speaker 01

  So, you're minimizing your exposure with that. And then you can rinse the food off, and you're likely going to vegetables, whatever, and you're probably going to be fine. So, real, whole foods, in terms of if you can afford organic.

• 1:12:31Speaker 01

  I'm not opposed to it. Not everybody can. I work with a lot of like really disabled, poor people who are on food stamps and other things and they don't have access to all organic. I don't, so I don't want people to come away from this feeling hopeless or like I don't, I don't have an option. You don't have to eat organic in order to dramatically improve your mental and metabolic health. So, but if you can, that could be a way to reduce your exposure to potentially harmful substances. I think those are some of the basics that I'm gonna go with. Great.

• 1:13:09Speaker 01

  And then it really leaves diet. And the, I think the most important message that I have on diet nutrition is that there is not a one size fits all diet for all humans. So I could give some generic advice and I, I will give a couple of generic tips. Please. But I want to make clear that if you are struggling with poor metabolic health or poor mental health or both, please learn a little more or work with a healthcare practitioner who understands the nuances of different dietary interventions and can help you figure

• 1:13:54Speaker 01

  that out. Or just if you learn about these things, you can try one after another, but know that the first one that you're trying might work for you. And if it doesn't, after two or three months, if you're not seeing improvement, move on to the next dietary strategy. Right. Don't, don't assume that, well, diet doesn't work for me or I'm following a healthy diet. And

• 1:14:21Speaker 01

  So I'll point out some really obvious reasons why that is. Some people are allergic to things that they don't even know about. Or they are sensitive to things like gluten that they don't even know about. And if you are somebody who is allergic or sensitive, some people are sensitive to probably food dyes and other artificial ingredients. And if you are one of those people, you may not know it until you eliminate that from your food and your diet plan. And you give it a few weeks and you see if you have improvement in symptoms. So I think the generic advice I would give is eat real, whole food. Avoid ultra-processed foods. Try to reduce the sweetness of your diet.

• 1:15:06Speaker 01

  Americans are hooked on added sugar, artificial sweeteners and other things. Do whatever you can to reduce the sweetness of your diet. Try not to consume calories in liquid form. So drink water, plain coffee, plain tea, you know, green tea, other types of things. But try to drink zero calorie without any added sweeteners, whether they're artificial non, you know, nutritive sweeteners. Try to just drink regular stuff. Now, some people hear this and they think, Chris Palmer, you are the most boring, awful, evil person in the world.

• 1:15:51Speaker 01

  No vaping, no drinking, no sweetness, no desserts, no ultra-processed foods. What a boring life that would be. And I literally talk to people who say, I'd rather be dead. I literally have had people say that. I would rather be dead than have to give all of that up. And here's the thing. I work with patients who have severe, crippling mental disorders. Schizophrenia, bipolar disorder, chronic unrelenting depression.

• 1:16:26Speaker 01

  And a lot of people are like, nobody can do a diet. Nobody can stick to a diet. Guess what? I get those people to stick to diets. So I don't accept that nobody can do a diet. And anybody who tells you that clearly doesn't know how to motivate people or how to educate people on how to do a diet and stick to it. So if your doctor is telling you, well, you just need to take a GLP-1 receptor agonist. Nobody can do a diet and stick with it. I disagree. I have had patients with schizophrenia lose 80 pounds, lose 160 pounds, and keep it off for over six years and going now. So if they can do it, you can do it.

• 1:17:08Speaker 01

  But when, you know, when I talk about give these things up, live a cleaner life, live a healthier life, live a more routine life, because I want people to be in a regular sleep pattern. Not be staying up all night erratically, not be partying all night. Like, the benefit, the people who think I would, I would rather be dead, I don't think those people truly understand how good life can feel, how good they can feel. Because invariably, after months and months of coaching and working with people,

• 1:17:51Speaker 01

  when I get people to slowly but surely adopt one after another of these things, when these things work for people, they actually will say, this is the best I have felt in my entire life.

• 1:18:07Dr. Darshan Shah?

  Exactly.

• 1:18:08Speaker 01

  I can't believe that I'm this person.

• 1:18:12Dr. Darshan Shah?

  Yeah. I see that all the time.

• 1:18:16Speaker 01

  And...

• 1:18:18Speaker 01

  And those people have just given up all of these vices that they thought they couldn't live without.

• 1:18:24Dr. Darshan Shah?

  Right.

• 1:18:26Speaker 01

  And now they feel more alive, more vibrant, more passionate than they've ever felt in their entire life.

• 1:18:35Dr. Darshan Shah?

  Yeah.

• 1:18:37Speaker 01

  And so, I just want to put that out there, that I get it. I get that when you're stuck in that rut, and the only thing that seems to give you pleasure is having your dessert of ultra-processed snack, your cookies, or brownies, or chips, or whatever you've got, whatever you are addicted to, your ice cream, whatever it is, whatever you feel like you're addicted to, or whether it's the alcohol, or the marijuana every night, or staying up late and going on social media, or binge-watching Netflix, or whatever. I fully understand and appreciate that people can get stuck in that and feel like there's

• 1:19:18Speaker 01

  no way out, and that having to give those things up means depriving them of the ounce of pleasure that they get once a day. But I'm here to tell you, there is a, there is a whole new world on the other side. And I just at least want people to know that, that there is a whole new world waiting for you.

• 1:19:41Dr. Darshan Shah?

  Beautifully said.

• 1:19:43Speaker 01

  Yeah.

• 1:19:44Dr. Darshan Shah?

  It's, it's hard for people to, like you say, you know, get over that feeling of giving things up. People don't like to give things up, but when you realize on the other side, how much you're actually getting from giving some of these smaller things up, it's just massive. It's exponential. And so, just sticking with it for a little bit of time and getting to the other side has made all the difference in my practice for my patients.

• 1:20:09Speaker 01

  Yeah, no, it really, you know, I think that if any of your listeners are kind of skeptical of this, they probably think you and I are making stuff up.

• 1:20:20Speaker 01

  That can't possibly be true, but it's actually really good and comforting and reassuring to me to hear that you're seeing the same thing. Because I talk to all of these clinicians. We're all seeing it. We're not making it up. We're not hallucinating these results in our patients. We're not just, you know, biased and only focusing on the 1% who get a benefit and the other people who aren't getting a benefit. We are seeing it over and over and over again.

• 1:20:52Dr. Darshan Shah?

  Exactly.

• 1:20:52Speaker 01

  People are reclaiming their lives. And it's not even, I, it's hard to even call it reclaiming their lives, because I don't think a lot of these people have ever had.

• 1:21:03Dr. Darshan Shah?

  Yeah, they don't even know what it feels like.

• 1:21:04Speaker 01

  Optimal mental and metabolic health.

• 1:21:07Dr. Darshan Shah?

  Right.

• 1:21:08Speaker 01

  They've been like this since childhood.

• 1:21:10Dr. Darshan Shah?

  Right.

• 1:21:11Speaker 01

  And when they get healthy for the first time in their life, you know, I'm, I'll at least share my own personal story. I was one of these people. I was one of these people who, in childhood, I ate all my, I had a nice diet of ultra-processed foods. I could not drink plain water. Who would want to drink plain water? It's so disgusting. It's tasteless, it's bland. Why would anybody do that to themselves when they can drink Kool-Aid or soda or whatever, like, or chocolate milk or strawberry milk or whatever? Like, and why would you ever drink plain milk? Of course, you've got to put sweetener in it.

• 1:21:51Dr. Darshan Shah?

  Of course, right.

• 1:21:52Speaker 01

  Because it's so much better. And I was one of those people, and I was miserable. And I felt like this is the best life I can have, that this is just what I get. And when I found my way a lot through serendipity, when I found my way to better metabolic health, it opened up an entirely new world of optimal mental health.

• 1:22:18Dr. Darshan Shah?

  For sure.

• 1:22:18Speaker 01

  That I didn't think was possible for me. And so when I say this, I just want people to know, like, I'm not standing high and mighty, not wagging a finger in anyone's face, not trying to say I'm better than anyone else. I was there. And what I feel is if I can get out of it, so can you. Like, if I can do it, you can too. I'm not that special.

• 1:22:40Dr. Darshan Shah?

  Right, right. I have the same story as you, Dr. Palmer. I was very sick 10 years ago and I got myself healthy through lifestyle interventions. And I feel so much better than I ever have in my entire life. And it's just, it didn't take that long, actually. It took maybe eight months, nine months of just sticking with the program. And it's just a miraculous change. And the mental health definitely follows the physical health 100%. And so, like you said, you know, a lot of people don't realize they can feel this good. It's not just in your body. It's also just the clarity of thought, the excitement for life, the waking up in the morning and wanting to be there that day, all day, the loving of seeing your friends and family.

• 1:23:22Dr. Darshan Shah?

  It's all just so magnified when you have good metabolic health. And so, to bring the definition of metabolic health out of just the physical body and into the mind as well, I think it's so important.

• 1:23:37Speaker 01

  Yeah, it really is.

• 1:23:39Dr. Darshan Shah?

  It really, really is.

• 1:23:39Speaker 01

  And, um, yeah, it truly is empowering. It, um, yeah, I just, I don't know how to get that through to any skeptical listeners.

• 1:23:49Dr. Darshan Shah?

  Exactly. I don't think they will be after this episode.

• 1:23:52Speaker 01

  I hope not.

• 1:23:53Dr. Darshan Shah?

  Dr. Palmer, you are such an inspiration and you provide so much hope for all the people struggling with mental illness. And just to have something new to try, a new perspective, I think it's so, it's such a game changer in the world of mental health. And I really want to thank you and applaud you for bringing this message to the forefront. And thank you so much for joining me today on X10.

• 1:24:16Speaker 01

  Thank you, Dr. Shaw.

• 1:24:18Dr. Darshan Shah?

  Thank you.

• 1:24:22Dr. Darshan Shah?

  How awesome was Dr. Palmer? Total game changer in my thinking of how depression, anxiety, even schizophrenia has its root causes in metabolic disease. So here are my top 10 takeaways from this episode. Number one, metabolic dysfunction is the hidden cause of mental illness. Mental disorders like depression, bipolar disorder, and schizophrenia share a common root, metabolic dysfunction occurring in your brain. Addressing your metabolic health could pave the way for transformative treatments that can help you virtually eliminate medications. Number two, Nearly all Americans have signs of poor metabolic health. There's an alarming 93% of US adults that exhibit at least one marker of metabolic dysfunction.

• 1:25:07Dr. Darshan Shah?

  These include insulin resistance, or even high blood pressure. These issues are directly related to brain disorders and cognitive decline. So treating metabolic health can help us reduce the signs of poor mental health. Number three, your brain is the first organ to suffer from poor nutrition. So while most of us think metabolic dysfunction can affect our heart or liver primarily, the brain is even more sensitive to dietary imbalances. Poor nutrition disrupts neurotransmitters, exacerbates inflammation in your brain, and impairs cognitive function. So it's incredibly important to get your nutrition right for your brain health. Number five, trauma and metabolic health form a vicious cycle.

• 1:25:51Dr. Darshan Shah?

  Trauma can directly impair metabolic function, leading to metabolic dysfunction in your brain. This in turn heightens the brain's susceptibility to future trauma and mental disorders, creating a cycle that self-perpetuates itself. Number six, processed foods wreak havoc on your brain. Ultra-processed foods are loaded with microplastics, inflammatory compounds, sugar, and other compounds that can disrupt your metabolism. Over time, they contribute to conditions like depression, anxiety, cognitive decline, and even Alzheimer's, which is known as diabetes type 3. Number seven, exercise can heal your brain at a cellular level. Physical activity triggers the release of myokines from your muscles.

• 1:26:36Dr. Darshan Shah?

  These are proteins that reduce inflammation, improve insulin sensitivity, and stimulate brain-derived neurotrophic growth factor, also known as BDNF. This protects you against depression and cognitive decline. Number eight, mental health care often overlooks the metabolism. So many psychiatrists focus on pharmaceuticals. They'll diagnose you with a mental illness, and they'll find the right medications to suppress the symptoms of that metabolic illness. However, sadly, most psychiatrists ignore how metabolic health impacts the mental illness that can be the root cause of it. So however, diet and lifestyle interventions often produce results that medications cannot achieve, it's really important to see a psychiatrist

• 1:27:19Dr. Darshan Shah?

  and a functional health doctor at the same time to treat both simultaneously.

• 1:27:25Dr. Darshan Shah?

  Number nine, early life nutrition shapes neurodevelopment throughout your life. The nutrition you have early on in your life actually shapes your neurodevelopment. So your mother's metabolic health and what you ate as a child, your early nutritional patterns, are crucial for preventing neurodevelopmental disorders. Poor metabolic health conditions in childhood are critical to leading to higher rates of autism and ADHD. Oftentimes, the symptoms of autism and ADHD are ameliorated by treating a child's metabolic health. And finally, number 10, lifestyle medicine is a cornerstone of metabolic health. Simple interventions like eliminating ultra-processed foods,

• 1:28:08Dr. Darshan Shah?

  sleeping to seven to nine hours a night, and practicing regular movement can dramatically improve both mental and metabolic health. These strategies treat the root cause of metabolic mental health illness and not just the symptoms. So that's my summary of this episode. If you know anyone that's struggling with mental health issues, please forward this episode to them. I think it'll really help them to seek a different approach to treating their mental illness by addressing their metabolic health.

• 1:28:39Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.