December 3, 2025 • 11 mins
This episode traces how metabolic dysfunction drives mood disorders—from brain energy failure and inflammation to insulin resistance that reshapes neural circuits—and lays out the emerging biomarkers and treatments that enable true precision mental health care. Rather than viewing depression and anxiety as purely psychological, we explore the biology beneath: metabolism, mitochondria, and immune signaling.
We begin with the data showing insulin resistance doubles depression risk, then map how cerebral glucose hypometabolism reduces energy supply to key mood-regulation regions. We explain the role of mitochondrial dysfunction across major psychiatric disorders and how inflammatory cytokines divert tryptophan away from serotonin production. You’ll learn why metabolic repair is becoming central to treatment.
The episode breaks down evidence for metformin’s support of the TCA cycle, the benefits of ketogenic therapy for metabolic syndrome and mood stability, and the value of targeted micronutrient testing—B vitamins, vitamin D, and omega-3s. We outline the key biomarkers clinicians now use: fasting insulin, CRP, and the TG/HDL ratio, alongside omics, CGMs, and AI tools that enable personalized interventions.
We close with a fundamental shift: moving from DSM symptom labels to measurable biology, unlocking precision treatment for mood disorders.
High-volume keywords used: metabolic health, insulin resistance, depression, mitochondrial dysfunction, inflammation, ketogenic therapy, biomarkers, precision psychiatry
Listener Takeaways
- How insulin resistance and glucose hypometabolism impair mood
- Why mitochondrial dysfunction is a shared driver across disorders
- The role of cytokines in reducing serotonin availability
- Evidence behind metformin, ketogenic therapy, and micronutrient testing
- Biomarkers and digital tools that enable precision mental health care
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This podcast is created by Ai for educational and entertainment purposes only and does not constitute professional medical or health advice. Please talk to your healthcare team for medical advice.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:00):
Welcome to the deep dive.
We are taking the latestresearch and transforming it
into clear, targeted insights,custom built just for you.
Today, we are getting into afield that is, and I'm not
exaggerating here, fundamentallyrewriting how we see mental
health.
It's called metabolicpsychiatry.
We're looking at sources fromabsolute leaders in this space,
(00:20):
including the director ofStanford's metabolic psychiatry
program, and they're allpointing to this massive
convergence of, well, medicineand the mind.
And look, here's the hook thatshould make this immediately
relevant to you.
The data shows one in threepeople in the United States have
some degree of insulinresistance.
And that single condition, allby itself, doubles your risk of
(00:40):
developing major depression,even with no prior psychiatric
history at all.
SPEAKER_00 (00:44):
That statistic is it's really terrifying because
it shows just how deeply thebody and brain are connected.
And that's what metabolicpsychiatry is all about.
It's the uh systematic study ofall metabolic dysfunctions.
SPEAKER_01 (00:55):
So not just in the brain, but everywhere.
SPEAKER_00 (00:57):
Exactly.
The ones happening systemicallyin the body and centrally in the
brain, and how they directlyimpact psychiatric disease, its
progression, its prevention, andmost importantly how we treat
it.
For you know, a hundred years,psychiatry has been almost
exclusively focused onneurotransmitters, just the
brain's internal chemistry.
(01:17):
This new field, it forces us tolook at the body-mind effect,
the physiological reality thatwhat happens in your gut, your
liver, your muscles, it'sprofoundly changing your brain.
SPEAKER_01 (01:28):
Aaron Powell It's like the ultimate system
failure.
I mean, we get it when a kidneyfails.
The body sends pain signals.
But when the brain is inflamedor starving for energy, it
doesn't hurt.
It just creates mental illness,anxiety, depression, psychosis.
SPEAKER_00 (01:40):
And this isn't a totally new idea.
If you go back a century,clinicians were already seeing
this.
They were noting markers of uhbioenergetic dysfunction, high
lactate, low glutathione, clearsigns the cells were struggling
for energy.
But then the pharmaceuticalrevolution came along and we got
hyper-focused on brainchemistry.
SPEAKER_01 (01:57):
And we missed the bigger picture.
SPEAKER_00 (01:58):
We missed that metabolism is the foundation
that brain chemistry is builton.
SPEAKER_01 (02:02):
Okay, so let's stick with that foundation.
When we say metabolism here,we're not just talking about
digestion, are we?
What's the scope?
SPEAKER_00 (02:07):
Not at all.
It's um it's incredibly complex.
It's the trillions ofbiochemical reactions happening
every single second in everysingle cell to create energy.
And here's the critical partevery single one of those
reactions needs specificvitamins and minerals as
cofactors to even work.
SPEAKER_01 (02:26):
And the crisis that the sources outline is that this
fundamental process is justbroken for most of us.
SPEAKER_00 (02:32):
It is, and it's alarming.
The sources say over 93% of theU.S.
population has some form ofmetabolic dysfunction.
SPEAKER_01 (02:39):
Wow.
SPEAKER_00 (02:39):
Yeah.
High blood pressure, high bloodsugar, abnormal cholesterol,
being overweight that allcounts.
And it's driven, well,overwhelmingly, by the modern
high sugar ultra-processed diet.
SPEAKER_01 (02:50):
And it's so easy for people to just think, oh, a bad
diet makes me gain weight.
But the link here is adevastating, vicious cycle,
isn't it?
SPEAKER_00 (02:56):
It's absolutely a vicious cycle.
When you're depressed, self-careis the first thing to go.
You eat poorly, you don'texercise.
SPEAKER_01 (03:02):
Which makes your metabolic state worse.
SPEAKER_00 (03:04):
Exactly.
And that worsens theinflammation, which then deepens
the depression, and on and on itgoes, spiraling downward.
To break that cycle, we have tolook at the mechanism.
And we see two core problemshappening at the same time, one
in the brain and one in thebody.
The central problem is somethingcalled cerebral glucose
hypometabolism.
SPEAKER_01 (03:24):
Which I'm guessing is just a very scientific way of
saying low brain energy.
SPEAKER_00 (03:28):
It is real brain energy, yes, but it's more
specific.
It's an efficiency problem.
It means certain parts of thebrain literally cannot use the
glucose that's right there,available to them.
SPEAKER_01 (03:39):
So the gas tank is full, but the engine can't pull
the fuel.
SPEAKER_00 (03:43):
That's a perfect analogy.
It's basically insulinresistance in the brain.
And what's really shocking fromthe research is the timing of
this.
SPEAKER_01 (03:50):
When it shows up.
SPEAKER_00 (03:50):
Right.
This energy failure, thishypometabolism has been shown to
be present before diagnosis ofpsychosis.
And before the patient has evertaken a single psychiatric
medication.
SPEAKER_01 (04:00):
That completely flips the script.
It's adjusts this metabolicfailure, isn't just a side
effect, it could be a rootcause.
SPEAKER_00 (04:07):
It seems to be.
And at the same time, you havethe peripheral problem, the
insulin resistance in the restof your body.
And that's not just affectingyour liver, it leads to actual
physical changes in the brain,degeneration and atrophy of
neurons in the hippocampus.
SPEAKER_01 (04:22):
Your memory and emotional center.
SPEAKER_00 (04:24):
Exactly.
So it's proof of thatbidirectional highway.
Bad metabolism in the bodystructurally damages the brain.
And then the psychiatricsymptoms mess up your
metabolism.
SPEAKER_01 (04:33):
Okay, let's connect this energy crisis back to
basics.
The brain is what?
2% of our body weight, but ituses 20% of our energy.
So where does that energyactually come from?
SPEAKER_00 (04:42):
It comes from the mitochondria, the little energy
factories in every cell.
And this is where the problemgets magnified.
In people with type 2 diabetes,their mitochondria function at
half the normal rate.
SPEAKER_01 (04:54):
And I'm guessing brain cells are packed with
them.
SPEAKER_00 (04:56):
They're the most mitochondria dense cells in the
entire body.
So if those factories aresputtering, the brain just can't
function properly.
SPEAKER_01 (05:03):
This idea of an energy deficit seems to connect
a lot of dots between diseaseswe used to think of as separate.
SPEAKER_00 (05:09):
That's the huge insight here.
The sources lay out four sharedmechanisms that link things like
Alzheimer's, schizophrenia,bipolar, and depression.
They all show issues withplasticity, so, growing new
connections, inflammation,oxidative stress, and of course
mitochondrial dysfunction.
SPEAKER_01 (05:27):
Let's drill down on inflammation.
People feel that one.
We know poor metabolic healthcauses high systemic
inflammation, right?
You can measure it with Creactive proteins, CRP.
SPEAKER_00 (05:37):
And this is the direct bridge to the old
neurotransmitter theory.
When you have all thatinflammation, the body releases
these markers called cytokines.
SPEAKER_01 (05:45):
Okay.
SPEAKER_00 (05:45):
Well, they don't just stay in the body, they
cross the blood-brain barrierand they directly interfere with
the synthesis of serotonin.
SPEAKER_01 (05:52):
How do they do that?
SPEAKER_00 (05:52):
They divert the raw material for serotonin, an amino
acid called tryptophan, awayfrom making serotonin and toward
making something calledkinerinine.
SPEAKER_01 (06:01):
And that's bad.
SPEAKER_00 (06:02):
That's very bad.
Kinerin is directly linked todepression and cognitive
problems.
So your bad diet is activelysabotaging the very chemical
that SSRIs are trying to boost.
SPEAKER_01 (06:13):
So we have to fix the fuel supply, not just tweak
the engine's chemistry.
SPEAKER_00 (06:16):
Which brings us to the exciting part the
treatments.
Metabolic therapies are powerfulbecause they target these root
causes.
SPEAKER_01 (06:24):
And a good starting point is actually a very old
drug, Metformin.
SPEAKER_00 (06:28):
Absolutely.
We're using it as a metabolicassist.
It's great because it crossesinto the brain, offering a
neuroprotective effect.
It actually helps the uh the TCAcycle inside the mitochondria
work better.
SPEAKER_01 (06:39):
Can you just quickly define the TCA cycle for us?
SPEAKER_00 (06:42):
Of course.
Think of it as the centralassembly line in your cellular
engine.
It takes fuel and turns it intoenergy the cell can actually
use.
Metformin helps that runsmoothly, and crucially, it
lowers inflammation.
Studies show it actually makestraditional psychiatric drugs
work much better intreatment-resistant bipolar
depression.
SPEAKER_01 (07:00):
Aaron Powell But the truly revolutionary stuff is
coming from nutrition,specifically the ketogenic diet
used as a metabolic therapy.
SPEAKER_00 (07:07):
The data from the Stanford Pilot Study is just
it's remarkable.
They took 23 patients of veryserious schizophrenia and
bipolar disorder.
Four month intervention.
SPEAKER_01 (07:16):
And the results.
SPEAKER_00 (07:17):
The physical results were incredible.
A 100% reversal of metabolicsyndrome.
Every single patient who had itwas cured of it in four months.
SPEAKER_01 (07:28):
100% is.
That's unheard of.
SPEAKER_00 (07:30):
It is.
And they saw a 12% average dropin body weight and a 36% drop in
that dangerous visceral bellyfat.
SPEAKER_01 (07:38):
And the mental health outcomes followed the
physical ones.
SPEAKER_00 (07:41):
They did.
Dramatic reductions inpsychiatric symptoms, better
sleep, higher life satisfaction.
And this is the key difference.
Traditional drugs have bad sideeffects, right?
Weight gain, fatigue.
This approach has good sideeffects.
You lose weight, you have moreenergy.
SPEAKER_01 (07:56):
Which makes you want to stick with it.
It creates a positive feedbackloop.
SPEAKER_00 (08:00):
Exactly.
SPEAKER_01 (08:00):
So what if keto isn't an option for someone?
What about just generalnutritional optimization?
SPEAKER_00 (08:05):
That's absolutely critical.
Because most people today are,as they say, overfed but
undernourished.
We have calories, but not themicronutrients, not the keys for
the machinery.
So clinicians have to test forthis stuff.
We're talking omega-3s, vitaminD, and especially the B,
vitamins B12, folate B6.
SPEAKER_01 (08:21):
The ones involved in methylation?
SPEAKER_00 (08:23):
Right, which is vital for making
neurotransmitters.
We also have to look at zinc,iron, and even supplementing
mitochondria directly withthings like CoQ10.
SPEAKER_01 (08:32):
So we're moving away from this brain-only solution.
It's about treating the wholeperson as a network.
It's root-cause medicine.
SPEAKER_00 (08:39):
And that means we need a totally new way to
diagnose the DSM-5, it justcategorizes symptoms.
We need objective, measurablebiomarkers.
SPEAKER_01 (08:46):
So what are the most important biomarkers clinicians
should be tracking right now?
SPEAKER_00 (08:51):
Well, beyond the basics like blood sugar and CRP,
the sources emphasize highaccuracy tests for insulin to
really nail down insulinresistance.
But here's a really fascinatingone: the triglyceride to HDL
ratio.
SPEAKER_01 (09:04):
High triglycerides, low good cholesterol.
SPEAKER_00 (09:07):
Yes, the classic signature of poor metabolic
health.
And that ratio is stronglyassociated with both the
severity and the chronicity, howlong the depression lasts.
SPEAKER_01 (09:15):
So it's not just if you're sick now, but a sign of
how long you've beenmetabolically unwell.
SPEAKER_00 (09:19):
Exactly.
And in bipolar disorder, insulinresistance correlates with more
rapid cycling, treatmentresistance, and very alarmingly
with suicidality.
Addressing this is life ordeath.
SPEAKER_01 (09:30):
To really personalize this, Stanford is
launching a huge new trial usingwhat they call the omics.
It sounds like a move towardstrue precision medicine.
SPEAKER_00 (09:38):
Aaron Powell It is.
The scale of the data isunprecedented.
They're collecting metabolomics,so every metabolite in the
blood.
They're collecting proteomics,all the proteins.
They're even looking atepigenetic data, which shows how
your lifestyle is literallyswitching your genes on and off.
SPEAKER_01 (09:53):
Aaron Powell, Why is that so much more revealing than
a normal blood test?
SPEAKER_00 (09:56):
A blood test is a snapshot.
Metabolomics shows what yourbody is actually doing right
now.
Epigenetics shows the history ofhow your diet or stress has
impacted your gene expression.
They're also using continuousglucose monitors, microbiome
testing, advanced mitochondrialtests.
I mean, the goal is to feed allof this data into AI models to
finally figure out who respondsbest to which specific
(10:17):
treatment.
SPEAKER_01 (10:18):
This is such a massive paradigm shift.
We're moving away from the DSM,a book of symptoms, toward
understanding the measurablemetabolic root causes of mental
illness.
And while the work starts withthe most severe cases like
schizophrenia, these principles,fixing energy, lowering
inflammation, they apply toeveryone, including those with
anxiety and depression.
SPEAKER_00 (10:39):
We're finally at a moment where our technology lets
us see this complexity.
You know, for decades,psychiatry was like looking at
the sky without a telescope.
Now with these omics tools,we're starting to see a whole
universe of metabolic pathwaysthat we can finally understand
and actually treat.
SPEAKER_01 (10:54):
It's about fixing the soil so the mind has a
chance to heal.
So as we wrap up this deep dive,consider this convergence.
Metabolic psychiatry is nowmerging with trauma informed
care, even psychedelic medicine.
If that deep psychologicalhealing, that enlightenment
depends on your brain workingoptimally, what simple,
measurable metabolic correctionlike fixing a B12 deficiency or
(11:14):
just stabilizing your bloodsugar do you need to make today
to allow for that deeper,lasting psychological progress?
Welcome to the deep dive.
We are taking the latestresearch and transforming it
into clear, targeted insights,custom built just for you.
Today, we are getting into afield that is, and I'm not
exaggerating here, fundamentallyrewriting how we see mental
health.
It's called metabolicpsychiatry.
We're looking at sources fromabsolute leaders in this space,
(00:20):
including the director ofStanford's metabolic psychiatry
program, and they're allpointing to this massive
convergence of, well, medicineand the mind.
And look, here's the hook thatshould make this immediately
relevant to you.
The data shows one in threepeople in the United States have
some degree of insulinresistance.
And that single condition, allby itself, doubles your risk of
(00:40):
developing major depression,even with no prior psychiatric
history at all.
SPEAKER_00 (00:44):
That statistic is it's really terrifying because
it shows just how deeply thebody and brain are connected.
And that's what metabolicpsychiatry is all about.
It's the uh systematic study ofall metabolic dysfunctions.
SPEAKER_01 (00:55):
So not just in the brain, but everywhere.
SPEAKER_00 (00:57):
Exactly.
The ones happening systemicallyin the body and centrally in the
brain, and how they directlyimpact psychiatric disease, its
progression, its prevention, andmost importantly how we treat
it.
For you know, a hundred years,psychiatry has been almost
exclusively focused onneurotransmitters, just the
brain's internal chemistry.
(01:17):
This new field, it forces us tolook at the body-mind effect,
the physiological reality thatwhat happens in your gut, your
liver, your muscles, it'sprofoundly changing your brain.
SPEAKER_01 (01:28):
Aaron Powell It's like the ultimate system
failure.
I mean, we get it when a kidneyfails.
The body sends pain signals.
But when the brain is inflamedor starving for energy, it
doesn't hurt.
It just creates mental illness,anxiety, depression, psychosis.
SPEAKER_00 (01:40):
And this isn't a totally new idea.
If you go back a century,clinicians were already seeing
this.
They were noting markers of uhbioenergetic dysfunction, high
lactate, low glutathione, clearsigns the cells were struggling
for energy.
But then the pharmaceuticalrevolution came along and we got
hyper-focused on brainchemistry.
SPEAKER_01 (01:57):
And we missed the bigger picture.
SPEAKER_00 (01:58):
We missed that metabolism is the foundation
that brain chemistry is builton.
SPEAKER_01 (02:02):
Okay, so let's stick with that foundation.
When we say metabolism here,we're not just talking about
digestion, are we?
What's the scope?
SPEAKER_00 (02:07):
Not at all.
It's um it's incredibly complex.
It's the trillions ofbiochemical reactions happening
every single second in everysingle cell to create energy.
And here's the critical partevery single one of those
reactions needs specificvitamins and minerals as
cofactors to even work.
SPEAKER_01 (02:26):
And the crisis that the sources outline is that this
fundamental process is justbroken for most of us.
SPEAKER_00 (02:32):
It is, and it's alarming.
The sources say over 93% of theU.S.
population has some form ofmetabolic dysfunction.
SPEAKER_01 (02:39):
Wow.
SPEAKER_00 (02:39):
Yeah.
High blood pressure, high bloodsugar, abnormal cholesterol,
being overweight that allcounts.
And it's driven, well,overwhelmingly, by the modern
high sugar ultra-processed diet.
SPEAKER_01 (02:50):
And it's so easy for people to just think, oh, a bad
diet makes me gain weight.
But the link here is adevastating, vicious cycle,
isn't it?
SPEAKER_00 (02:56):
It's absolutely a vicious cycle.
When you're depressed, self-careis the first thing to go.
You eat poorly, you don'texercise.
SPEAKER_01 (03:02):
Which makes your metabolic state worse.
SPEAKER_00 (03:04):
Exactly.
And that worsens theinflammation, which then deepens
the depression, and on and on itgoes, spiraling downward.
To break that cycle, we have tolook at the mechanism.
And we see two core problemshappening at the same time, one
in the brain and one in thebody.
The central problem is somethingcalled cerebral glucose
hypometabolism.
SPEAKER_01 (03:24):
Which I'm guessing is just a very scientific way of
saying low brain energy.
SPEAKER_00 (03:28):
It is real brain energy, yes, but it's more
specific.
It's an efficiency problem.
It means certain parts of thebrain literally cannot use the
glucose that's right there,available to them.
SPEAKER_01 (03:39):
So the gas tank is full, but the engine can't pull
the fuel.
SPEAKER_00 (03:43):
That's a perfect analogy.
It's basically insulinresistance in the brain.
And what's really shocking fromthe research is the timing of
this.
SPEAKER_01 (03:50):
When it shows up.
SPEAKER_00 (03:50):
Right.
This energy failure, thishypometabolism has been shown to
be present before diagnosis ofpsychosis.
And before the patient has evertaken a single psychiatric
medication.
SPEAKER_01 (04:00):
That completely flips the script.
It's adjusts this metabolicfailure, isn't just a side
effect, it could be a rootcause.
SPEAKER_00 (04:07):
It seems to be.
And at the same time, you havethe peripheral problem, the
insulin resistance in the restof your body.
And that's not just affectingyour liver, it leads to actual
physical changes in the brain,degeneration and atrophy of
neurons in the hippocampus.
SPEAKER_01 (04:22):
Your memory and emotional center.
SPEAKER_00 (04:24):
Exactly.
So it's proof of thatbidirectional highway.
Bad metabolism in the bodystructurally damages the brain.
And then the psychiatricsymptoms mess up your
metabolism.
SPEAKER_01 (04:33):
Okay, let's connect this energy crisis back to
basics.
The brain is what?
2% of our body weight, but ituses 20% of our energy.
So where does that energyactually come from?
SPEAKER_00 (04:42):
It comes from the mitochondria, the little energy
factories in every cell.
And this is where the problemgets magnified.
In people with type 2 diabetes,their mitochondria function at
half the normal rate.
SPEAKER_01 (04:54):
And I'm guessing brain cells are packed with
them.
SPEAKER_00 (04:56):
They're the most mitochondria dense cells in the
entire body.
So if those factories aresputtering, the brain just can't
function properly.
SPEAKER_01 (05:03):
This idea of an energy deficit seems to connect
a lot of dots between diseaseswe used to think of as separate.
SPEAKER_00 (05:09):
That's the huge insight here.
The sources lay out four sharedmechanisms that link things like
Alzheimer's, schizophrenia,bipolar, and depression.
They all show issues withplasticity, so, growing new
connections, inflammation,oxidative stress, and of course
mitochondrial dysfunction.
SPEAKER_01 (05:27):
Let's drill down on inflammation.
People feel that one.
We know poor metabolic healthcauses high systemic
inflammation, right?
You can measure it with Creactive proteins, CRP.
SPEAKER_00 (05:37):
And this is the direct bridge to the old
neurotransmitter theory.
When you have all thatinflammation, the body releases
these markers called cytokines.
SPEAKER_01 (05:45):
Okay.
SPEAKER_00 (05:45):
Well, they don't just stay in the body, they
cross the blood-brain barrierand they directly interfere with
the synthesis of serotonin.
SPEAKER_01 (05:52):
How do they do that?
SPEAKER_00 (05:52):
They divert the raw material for serotonin, an amino
acid called tryptophan, awayfrom making serotonin and toward
making something calledkinerinine.
SPEAKER_01 (06:01):
And that's bad.
SPEAKER_00 (06:02):
That's very bad.
Kinerin is directly linked todepression and cognitive
problems.
So your bad diet is activelysabotaging the very chemical
that SSRIs are trying to boost.
SPEAKER_01 (06:13):
So we have to fix the fuel supply, not just tweak
the engine's chemistry.
SPEAKER_00 (06:16):
Which brings us to the exciting part the
treatments.
Metabolic therapies are powerfulbecause they target these root
causes.
SPEAKER_01 (06:24):
And a good starting point is actually a very old
drug, Metformin.
SPEAKER_00 (06:28):
Absolutely.
We're using it as a metabolicassist.
It's great because it crossesinto the brain, offering a
neuroprotective effect.
It actually helps the uh the TCAcycle inside the mitochondria
work better.
SPEAKER_01 (06:39):
Can you just quickly define the TCA cycle for us?
SPEAKER_00 (06:42):
Of course.
Think of it as the centralassembly line in your cellular
engine.
It takes fuel and turns it intoenergy the cell can actually
use.
Metformin helps that runsmoothly, and crucially, it
lowers inflammation.
Studies show it actually makestraditional psychiatric drugs
work much better intreatment-resistant bipolar
depression.
SPEAKER_01 (07:00):
Aaron Powell But the truly revolutionary stuff is
coming from nutrition,specifically the ketogenic diet
used as a metabolic therapy.
SPEAKER_00 (07:07):
The data from the Stanford Pilot Study is just
it's remarkable.
They took 23 patients of veryserious schizophrenia and
bipolar disorder.
Four month intervention.
SPEAKER_01 (07:16):
And the results.
SPEAKER_00 (07:17):
The physical results were incredible.
A 100% reversal of metabolicsyndrome.
Every single patient who had itwas cured of it in four months.
SPEAKER_01 (07:28):
100% is.
That's unheard of.
SPEAKER_00 (07:30):
It is.
And they saw a 12% average dropin body weight and a 36% drop in
that dangerous visceral bellyfat.
SPEAKER_01 (07:38):
And the mental health outcomes followed the
physical ones.
SPEAKER_00 (07:41):
They did.
Dramatic reductions inpsychiatric symptoms, better
sleep, higher life satisfaction.
And this is the key difference.
Traditional drugs have bad sideeffects, right?
Weight gain, fatigue.
This approach has good sideeffects.
You lose weight, you have moreenergy.
SPEAKER_01 (07:56):
Which makes you want to stick with it.
It creates a positive feedbackloop.
SPEAKER_00 (08:00):
Exactly.
SPEAKER_01 (08:00):
So what if keto isn't an option for someone?
What about just generalnutritional optimization?
SPEAKER_00 (08:05):
That's absolutely critical.
Because most people today are,as they say, overfed but
undernourished.
We have calories, but not themicronutrients, not the keys for
the machinery.
So clinicians have to test forthis stuff.
We're talking omega-3s, vitaminD, and especially the B,
vitamins B12, folate B6.
SPEAKER_01 (08:21):
The ones involved in methylation?
SPEAKER_00 (08:23):
Right, which is vital for making
neurotransmitters.
We also have to look at zinc,iron, and even supplementing
mitochondria directly withthings like CoQ10.
SPEAKER_01 (08:32):
So we're moving away from this brain-only solution.
It's about treating the wholeperson as a network.
It's root-cause medicine.
SPEAKER_00 (08:39):
And that means we need a totally new way to
diagnose the DSM-5, it justcategorizes symptoms.
We need objective, measurablebiomarkers.
SPEAKER_01 (08:46):
So what are the most important biomarkers clinicians
should be tracking right now?
SPEAKER_00 (08:51):
Well, beyond the basics like blood sugar and CRP,
the sources emphasize highaccuracy tests for insulin to
really nail down insulinresistance.
But here's a really fascinatingone: the triglyceride to HDL
ratio.
SPEAKER_01 (09:04):
High triglycerides, low good cholesterol.
SPEAKER_00 (09:07):
Yes, the classic signature of poor metabolic
health.
And that ratio is stronglyassociated with both the
severity and the chronicity, howlong the depression lasts.
SPEAKER_01 (09:15):
So it's not just if you're sick now, but a sign of
how long you've beenmetabolically unwell.
SPEAKER_00 (09:19):
Exactly.
And in bipolar disorder, insulinresistance correlates with more
rapid cycling, treatmentresistance, and very alarmingly
with suicidality.
Addressing this is life ordeath.
SPEAKER_01 (09:30):
To really personalize this, Stanford is
launching a huge new trial usingwhat they call the omics.
It sounds like a move towardstrue precision medicine.
SPEAKER_00 (09:38):
Aaron Powell It is.
The scale of the data isunprecedented.
They're collecting metabolomics,so every metabolite in the
blood.
They're collecting proteomics,all the proteins.
They're even looking atepigenetic data, which shows how
your lifestyle is literallyswitching your genes on and off.
SPEAKER_01 (09:53):
Aaron Powell, Why is that so much more revealing than
a normal blood test?
SPEAKER_00 (09:56):
A blood test is a snapshot.
Metabolomics shows what yourbody is actually doing right
now.
Epigenetics shows the history ofhow your diet or stress has
impacted your gene expression.
They're also using continuousglucose monitors, microbiome
testing, advanced mitochondrialtests.
I mean, the goal is to feed allof this data into AI models to
finally figure out who respondsbest to which specific
(10:17):
treatment.
SPEAKER_01 (10:18):
This is such a massive paradigm shift.
We're moving away from the DSM,a book of symptoms, toward
understanding the measurablemetabolic root causes of mental
illness.
And while the work starts withthe most severe cases like
schizophrenia, these principles,fixing energy, lowering
inflammation, they apply toeveryone, including those with
anxiety and depression.
SPEAKER_00 (10:39):
We're finally at a moment where our technology lets
us see this complexity.
You know, for decades,psychiatry was like looking at
the sky without a telescope.
Now with these omics tools,we're starting to see a whole
universe of metabolic pathwaysthat we can finally understand
and actually treat.
SPEAKER_01 (10:54):
It's about fixing the soil so the mind has a
chance to heal.
So as we wrap up this deep dive,consider this convergence.
Metabolic psychiatry is nowmerging with trauma informed
care, even psychedelic medicine.
If that deep psychologicalhealing, that enlightenment
depends on your brain workingoptimally, what simple,
measurable metabolic correctionlike fixing a B12 deficiency or
(11:14):
just stabilizing your bloodsugar do you need to make today
to allow for that deeper,lasting psychological progress?
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