July 24, 2024 • 28 mins
How do clinicians learn to hold hands integrating cutting edge and long term research into clinical practice? Dr. James Greenblatt of Psychiatry Redefined joins TheNPRD podcast inclusive of his fellowship program, a rich discussion on ADHD and why women are diagnosed later in life, and what nutritional guidelines can enhance the diagnosis and treatment of … Continue reading We Didn’t Learn This In School
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(00:01):
Hello,
and welcome to the Npr
podcast,
with nurse practitioner and registered diet.
Robin K.
Eating disorders, body image, medicine, they are all
interconnected.
But with so many programs,
techniques and advice to choose from it's easy
to be overwhelmed.
(00:21):
Robin with more than 25 years of experience
as a nurse practitioner, and registered diet offers
help and hope for everyone. Families,
children,
and adults.
Along with veteran talk show host and good
friend, Jordan Rich,
Robin invites you to learn much more right
here, on the N npr
(00:44):
podcast.
Welcome back to the N npr podcast. Today
we are very lucky to have doctor Jim
Green on with us today. Welcome. Thank you.
Good to be with you ron. Yeah. So
I'm gonna read your bio.
A pioneer in the field of functional and
integrative medicine, board certified child and adult psychiatrist,
(01:05):
James Green,
has treated patients since 19 88. After receiving
his medical degree in completing his psychiatry residency
at George Washington University
Doctor Green completed a fellowship in child and
adolescent psychiatry at Johns Hopkins medical school. He
currently serves a the chief Medical officer at
Walden behavioral care denim mass. Doctor Green has
(01:26):
lecture internationally on the scientific evidence for nutritional
interventions in psychiatry and Mental, illness. He is
the author of 7 books, including answers to
An,
finally focused the breakthrough natural treatment plan for
Adhd and his more recent book functional and
integrative medicine for anti
withdrawal, which was recently released, Doctor Green was
(01:48):
ind into the ortho molecular hall of fame
in 20 17 by the international Society of
Ortho molecular medicine.
Is the founder of psychiatry redefined an educational
platform dedicated to the transformation of psychiatry, which
offers online courses
educational webinars and fellowship ships for professionals. And
I'm gonna say these websites now, and then
(02:09):
I'll say them again. You can find everything
about doctor Green, at WWW
dot psychiatry read redefine dot org
or WWW
dot James green
GREENBLATDMD
dot com. I'm so glad you're here. Thank
you. Yeah. Very nice to be with you
again. Yeah. I like to tell how we
(02:31):
met I heard you speak at a Meta
conference
in... I don't even know maybe 20 12
something along time... I don't maybe you could
look, think about when you presented there, and
I was, like, very in awe.
And I thought I need to learn more
from this person.
And then I, kind of, I think begged
you for a job at Walden. Thank you
(02:53):
Instead. Will you let me work with you
so I can learn more, and it was
amazing, and I I learned so much, and
you have...
1 of the the things I like to
do on this podcast is is have people
in the field of eating disorders, but also
have people who are entrepreneurs in the field,
and you are such an amazing entrepreneur
with all the things that you've developed with
(03:15):
psychiatry redefined. And so that's huge to me
so to kinda of be able to pick
your brain about all those things. Great. Yeah.
No. I I came into the field of
eating disorders kinda by accident
about 25 years ago. And this was
before walled in, it was a community hospital
walt in Hospital I was cheapest psychiatry, and
we just had a 6 bed eating disorder
(03:36):
unit.
So it wasn't by choice, and it was
just getting exposed
25 years ago to the field and the
current treatment models.
That something just didn't make sense to me.
Mh. And since then trying to sort it
out.
And I remember Walt.
Like I was working up here back in
the day. So I remember that. What I
(03:56):
really wanna focus on today, I want you
to be able to share with folks little
some of the upcoming coursework. You have a
fellowship starting in July. Can you speak to
that a bit? Sure. My energies have been
devoted, you know, over the past 5 years.
To training clinicians. So, psych nurse, practitioners, psychiatrists,
natural breath diet,
(04:17):
anyone that's interested in learning
a model of treating mental health
based in these concepts of nutritional site and
metabolic site,
a more holistic approach,
And so we have short courses,
and then we have a year long fellowship,
but we take people through
the
(04:38):
training of how to integrate this into practice.
Everyone that I've been working with recently
says the same thing. We didn't get this
in school.
Nobody he learns about nutrition and mental health.
Now he learns about
metabolic,
insulin resistance and how it affects. Mh brain
function. So we're really kinda holding hands helping
people integrate this material into clinical practice. You
(05:00):
also very much specialize and we talked about
it in regard to 1 of your books
in Adhd. And I'd love to hear from
you the... I guess the first question I
have is are are females
actually diagnosed later than males. This is a
statistic that I hear over and over and
over, and I think in my own clinical
practice, I definitely see women
(05:22):
who, you know, definitely have
Adhd without question and yet had never been
diagnosed.
So what are your thoughts on that statistic?
Yeah. I'm not as up on the research
last few years, but clinically,
absolutely. I've haven't seen it for for 30
years. So was a child just, you know,
most of what I did 30 years ago
was Adhd set up Adhd clinics.
(05:45):
So that is how I got my start
in kinda looking at nutrition and mental hell.
And what happens,
the the bad news is women tend to
be smarter,
and they tend to not have the hyper
activity and in imp.
Yeah. So they're the attention problems,
And since
many of these young girls are are smart
(06:06):
enough to do fine in school,
they're not picked up.
And
and then in middle school, some problems,
but I've seen so many kids fall apart
in high school.
Because of
the profound in attention, poor persistent of effort
that interferes with their
(06:28):
ability to achieve up to the potential.
And then, you know, the the other piece
to that is we also see a high
correlation with eating disorder is Right. And these,
young women with Adhd. So what would you
say are some of the pearls in terms
and this is a short question for such
a big topic because you do a whole
course on this in your psychiatry redefined
(06:52):
you know, Institute. But what are some of
the Pearls
nutritional to treating
Adhd?
Sure. I mean, the whole... Fun purpose of
our program is to say that everyone's different.
It's hard to come up with protocols.
But I think,
for
Adhd, the research and my clinic experience
has demonstrated that almost every child, adult, male
(07:15):
and female,
deficient in magnesium.
A 1 clinical pearl is without testing a
magnesium is a micron nutrient that I would
recommend for everyone. Yeah. I believe there has
to be some...
Genetic
component to this
because it's not necessarily dietary
related, be on the healthiest diet,
(07:35):
and still benefit from magnesium. So magnesium is
1 of the most
common nutrient deficiencies.
The other kind of,
overarching
thing that we could say for everyone is
some,
you know, the less
processed foods
sugar,
the better. I mean the research is quite
(07:56):
stunning. Mh. The amount of sugar sweetened and
beverages and processed foods,
the rates just go up pretty
dramatically.
And as parents and clinicians, we're not gonna
have everybody eating this, you know, ideal diet.
So I think the simplest intervention is, helping
people,
just put back more protein.
(08:16):
Yeah. To minimize that... Sugar. And modeling. Right?
Parental modeling.
Absolutely of of what we want our kids
to to try to think about... What about
Omega threes? III
This is a topic that's a great interest
to me.
And so how do you see that in
terms of any kind of an Adhd crossover
of treatment. Yeah. I mean, I think that
(08:38):
would be kind of third on my list
as likely, but not everyone. So Mh. You
know, the research is pretty good.
Yeah
but great. Because there are gonna be Adhd
kids that are eating adequate fish and have
Yeah. Adequate it'll omega a 3 when we
test. Mh. But I would say if we
were taking our educated guesses,
both clinically and the research
(09:00):
that
the essential fatty acids are usually deficient.
I think there's just as good research,
looking at not just the omega threes, but
the essential omega 6 is, Mh. Like P
oil as well as omega 3. So all
the earliest studies had
combination products. So that's typically my recommendation.
(09:22):
Is providing the essential omega threes and the
Omega sixes. I find it very interesting because
metabolically, the omega six's are shifted it when
we utilize them in the brain? Correct? So,
like, where do they go to help us
versus the omega 3? What's the difference then?
(09:42):
Yeah. They... Their precursor is to, you know,
hundreds of messengers.
And clearly, a lot of the...
You know, seed oils and the baked vegetable
oils that we're using are very high
and that, omega 6 is,
But there's still...
People get confused, but there's still what we
call essential omega 6 is the body can't
(10:04):
do without. Right. And,
just like omega threes.
And
so I have seen
problems with people just taking high dose omega
threes,
people taking 6 or 10 grams
and That's a lot. Yeah. And then the
omega sixes is. It's like a seesaw. The
omega 6
it down and and I see depression and
(10:26):
other problems.
So what I'm referring to is just
the,
the Gl and the omega sixes that are
Yep. In evening p oil, a small amount
with the omega threes,
have been,
according to some of the better research, a
little more helpful,
for Adhd. So I don't want... Thank you
(10:48):
for that. I don't wanna get 2 into
specific eating disorder, like, 1 versus the other,
but I was just at... The Meta conference
a while back, I was listening to Wendy
Oliver Pi who quoted you, and I would
love to read her quote because I thought
that was very cool.
And she was talking about Adhd and she
wrote, or she had a slide that had
(11:10):
this quote from you, there appears to be
a significant
overlap in terms of involved
neural circuitry,
both Adhd and Demons straight abnormalities and reward
and response
inhibition
in addition to emotional processing and regulation.
And so just I guess briefly because we
(11:31):
could talk for so many hours.
You know, in terms of that
response
inhibition,
and treating that, helping a person regulate and
regulate their emotional processing
based on what
how you practice and how you've learned and
how you're teaching other clinicians. It's really the
the crossover of treating nutritional deficiencies, Right? Whether
(11:55):
that be supplemental or nutritional with food?
And then
how much would you say the cycle farm
psycho pharmacology really comes into that. Yeah. I
mean, I think the overarching
issue for me and we're we're... Disagree with
most of the eating disorder community is... I'm
not afraid to use the word food addiction.
You know, not everyone with binge eating disorder,
(12:17):
So has food addiction. But there's a subset
that does.
And by not acknowledging that, I just find
it a tremendous to disservice
to patients that are really struggling. Mh.
And too much of the sort community just
kinda of puts it into
this kind of behavioral
treatment program. So if we understand that,
(12:40):
addiction,
whether it's alcohol or or certain food, and
it's not food. It's not broccoli or rice.
It is
the Msg and the chemicals that refined sugar
or all the other components that we're eating
So food addiction might not be the best
term.
But so when we think of it that
way, my job is to relieve that suffering.
(13:03):
And, I think,
I guess I could say this, you know,
Gl 1, you know,
revolution.
As some
both good and bad
consequences, but 1 thing from me me at
least it has and validated what I've been
trying to say for 30 years is that
often oftentimes cheating is biologically
driven. Mh. And that's what these medicines have
(13:25):
hip people realize. So the punchline for me,
to answer your question, I would do whatever
it takes
to help someone
regulate
this out of control appetite. Often oftentimes we
can do with nutrients with amino acids,
but sometimes we need medicines.
And
once we can get that kinda appetite under
(13:45):
control,
then all the cognitive behavioral therapy
and mindful eating and all the other tools
that are
we we know my help is just better
utilized. Let's talk about the Gl ones for
a sec 2 around
noise.
So I don't prescribe them, but I share
patients with other clinicians who do prescribe them,
(14:07):
and it's this is the case by case
basis an individualized approach. 1 of the common
themes is the noise goes away.
And to your point,
if the noise goes away, then
these other pieces can actually be
looked at and treated and
helping that person have
(14:27):
the full life they're looking for.
Absolutely.
And,
I don't prescribe Gl ones either.
But I I think they have a a
important role,
for diabetes and and maybe for, binge eating,
a new review article just came out.
But just as you described,
(14:48):
when the biology and the brain changes.
Then
we can and make a huge difference for
our patients.
And, you know, I'm actually giving a talk
Monday night,
it'll be recorded if this comes out and
after, just a a webinar
on amino acid therapy.
To that ged.
(15:08):
And and the hormone Gl 1 is is
a
is a peptide made up of 30 amino
acids.
So if we don't have those adequate,
you know, essential amino acids aren't body. We're
not gonna be able to build our own
and a hormones that regulate
appetite. So there is a kind of nutritional
approach
(15:29):
that can support
in the same biological way these meds can.
Mh.
I really appreciate how you put that.
That
that makes a lot of sense.
1 of the questions I like to ask
because you are an entrepreneur. So I kind
of, I feel like I can answer this
myself in a way is where you see
the field going versus where it's going?
(15:52):
You've been chief Medical officer,
right, held
bigger positions at Walden behavioral care. You've had
a private practice. Now you're educating other clinicians.
Is this where you see the field really
going? Like, it is for you in your
career? In terms of eating disorders per s,
where do you see the field going versus
(16:14):
where it's going? And are they... Are they
the same and... Or are they different? Well,
I think they're different. I was recently at
the American Psychiatric
Association
conference?
Are 12000
psychiatrists just from around the world
with every drug company,
you know, having exhibit booths. And I was
just struck by how many people were interested
(16:36):
in a nutritional site and and the work
that we're doing.
So
I think a
psychiatry mental health, our psycho,
particularly our nurse practitioners are just understanding that
there's a path.
Beyond psycho... Just psycho farm. Yeah. None of
us have given up our prescription paths, but
there's so much as you know, we can
(16:57):
do.
I have to say the eating disorder of
community lags far behind.
Mh. And be this disorder of community.
It's still resistant to nutritional supplements
is resistant to looking
a deeper,
and
seeing what's right in front of them, which
are very malnourished
(17:18):
patients regardless of a body size. Right. Complete,
These use profound micron nutrient deficiencies
that
I think it's really sad that our community
has really lost sight of that.
Do you feel like you with your Institute?
I mean, you're changing that?
I'm trying as what are people that are...
(17:40):
This year, we're actually, we're gonna have a
a binge eating disorder intensive, So 6 weeks
going through all the material, so starting in
the summer.
And I will do a an
training. Again, trying to help people appreciate.
Micron nutrient deficiencies. Mh.
And an Ocd training in the fall. So
(18:00):
we are trying to educate
those that that want more information,
I really like how you're doing that too
just from a business standpoint for clinicians because
you have the the longer fellowship.
You have these webinars you're doing. But you
also have these shorter
sections of ways that folks can learn
(18:20):
very specific to me with their populations, but
also from a time
perspective. It's it's maybe more doable for a
clinician.
Yeah. No. That... That's been my thinking. And...
Not only do we have the courses, like,
for the binge eating
program, but it'll be, you know, 6 hours
of recorded?
But then supervision. So people can ask the
(18:42):
question, You know, what do you mean about
by amino acid therapy? Right. You know, How
do we test for
this. So really trying to make it practical
where people can utilize this material their practice
is to help more patients.
What do you say? I wanna go back
to Adhd for a second. When you see
a new patient
who
(19:02):
has this diagnosis?
Parents have been avoiding
really any kind of treatment. How do you
approach
parents who are very
re
about anything
in terms of treatment.
And how would you how would you recommend
to other clinicians that they might
(19:23):
help parents. These are parents say of minor
children right under 18,
become comfortable
with
a crossover,
you know, the multi level treatment
that a person,
a younger person with this diagnosis, it could
be anybody, but this is just are just
parents. How do you how do you approach
them
(19:43):
and try to get them on board. Sure.
I think the most important is is education.
And if we start by helping... These Parents
understand this is a neuro
illness. It's not low power is not bad
behavior,
and as nobody's fault. So if we... Say
that 1 more time. Say the 1 more
time for everybody because people really don't understand
that. Yeah. No. The most important thing I
(20:05):
can share with clinicians or parents.
Is if we have a diagnosed of Adhd,
then we're helping,
everyone understand is a neuro
disorder
don't know all the details, but we have
a pretty good understanding of
receptors and neurotransmitters.
And that the symptoms, the imp,
(20:26):
the over activity and the poor attention, and
and
for motivation, it... These are biologically
driven
symptoms. So if we can help parents understand
that and
get rid of the blame game.
Certainly get rid of the... This is bad
behavior. They're doing it on purse purpose, just
upset us.
(20:47):
And then I just try to outline,
we need a biological
approach,
and and we can do it a number
of different ways, and there... Some families that
are just against medications and we say, well,
we can dig deeper and look at
nutrition and testing
that there might be
elevations of lead or copper, that might be
(21:07):
deficiencies of magnesium.
So we could do that for 3 months.
And support the parents in education.
And if a child is suffering and is
not doing well at school and poor social
relationships. Then my job is to help convince
them that there are medications that could help.
Mh. And I think they'll trust you more
(21:27):
if you can appreciate.
And work with them about, you know, what
their preferences are. Some people are are desperate,
and they come in, the child needs medicine
and the parents, appreciate the role of medicine.
And and there's the place for that in
some of these young kids that are really
suffering and not living up to their certainly
academic potential.
(21:48):
What do you think about this, the new
medication Quell? Just curious. Yeah. I mean, I
would just say interesting and then... I haven't
seen great results. I haven't prescribed it, but
I've seen some often on it. I I
just think the stimulant tour.
So well, so simple and so safe.
That with an integrative nutritional approach,
(22:10):
often we don't need more medications. Yeah. I
think it's also important for parents to hear
I don't know if you say this, but
this is this statistic that I've read and
seen in research that most folks who do
take stimulants for
Adhd, do not then they're not addicted.
Right? There's this fear, I think that parents
(22:31):
have about addiction around stimulants.
Yeah. Absolutely not. I mean, many kids can
get off it. And
I think the research that I quote all
the time is the kids that took the
medications were the ones that had...
Less addiction. Yeah. In in their future. Because
they were treated it. Right. They did okay
in school. They did okay in life, and
they didn't have to hang out in the
(22:51):
back of the school
you know, getting high. Mh. Because they were
failing. Mh. Yeah. So... Yeah.
Do you feel like there's still a role
for something like an ad?
In treatment. Do you still use that ever?
No. It hasn't been a a favorite of
mine. I I've sent... You know, this because
success is some limited. I mean, it's occasional,
it's hard to predict.
(23:13):
So, you know, I still use gu.
Mh. And I I'd still use the stimulants,
and I would say, with the nutritional approach,
looking at everything from
genetic testing to micron
deficiencies,
that's pretty much the the bulk of what
my practice has been for many years.
(23:33):
I spoke to Daniel Doubt the other day?
Up from Gen,
because any person that I see who does
the gen genetic testing, I'll do a call
with 1 of the clinicians there. I know
he up spoke to you on a webinar
or something recently.
And we were talking about the
differentiation between
some people being more responsive to meth
(23:56):
versus some peep people being more responsive to
amp.
And I wonder if you see that in
practice.
Yeah. I see it all the time, sometimes,
the the genetic. Testing can guide us. Sometimes
it's just kinda clinical experience, but
absolutely,
you know,
to me, I've seen a big difference, testing
(24:17):
between the in and the meth.
Mh.
So what's on horizon for you your... Kidding
lots of clinicians, will you be writing another
book? Are you writing another book? Tell us,
tell us what to look for? Well, well,
great question. Yeah. Actually just
completed a a theoretical deal not signed, but
(24:38):
I'm gonna be writing a book on a
functional medicine for depression.
Nice.
And then the finely focused book,
we just agreed to do a second edition.
So to update the Adhd material, so it's
relevant for 20 24
and beyond. That was first written in 20
17.
So my focus this year will be on
(24:58):
finishing a book on
functional medicine for depression,
It is a... A number 1 disability in
the globe,
you know, hundreds of millions of people suffering,
and our treatment model.
Is just barely better than, you know, placebo,
50 percent. So I think a functional medicine
approach and really kinda augment our model. Mh.
(25:20):
That's my priority this year.
And you have these
different trainings coming up right this summer for
binge eating disorder. I think you said An
and Ocd? Yes. These are about 5
to 6 weeks of training.
Or And then the fellowship
starts again in July. Right. That's our. It's
(25:41):
actually a 2 year program now. 1 year
of
kind of
guided
supervision and mentorship. And I wanna just review
again so folks can find you around the
globe. So
Doctor James Green can be found at
psychiatry
redefine dot org
or James green,
GREENBLATTMD
(26:04):
dot com. My last question I have for
you is would you take your own advice?
Professionally or personally, and you can say no.
But I'm just curious, would you take your
own advice and if you would, What would
it be?
Well, certainly, absolutely, I I think when we
were all young
that
there were times probably I was too busy
(26:25):
to... You know, Do all the things we
know we should do. But certainly,
at this point, treating in a patience and
understanding the role of
you know,
connections and diets and help and sleep and
lifestyle and stress,
absolutely. I would be very
(26:46):
easily kind of appreciate the role of nutrition
and now.
Way back in the in the early days.
I wrote a paper in college on,
you know, a nutrition and brain function. There
was a group of us.
I I think we would would be... In
the 19 seventies, there was a student group
we were wrote how to eat your way
over a 4.
(27:07):
I love that title. Nutrition, nutrition
and brain hall. Okay. So you have taken
your own advice then professionally, really?
Absolutely. Yes. Yeah. Thank you so much, Jim
for your time today. I really appreciate it.
I I really do learn from you every
time I get to talk to you. So
thank you. Thank you for. No. Thanks for
spreading the word and doing the work that
(27:28):
you're doing.
Thank you for joining us for the N
npr
podcast with Robin K. We invite you to
subscribe, download, rate and review us and share
this valuable podcast with Friends and family.
Help and hope is found here. For more,
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(27:50):
That's R0BYNKIEVIT
dot com or check out VNPRD
dot com.
Hello,
and welcome to the Npr
podcast,
with nurse practitioner and registered diet.
Robin K.
Eating disorders, body image, medicine, they are all
interconnected.
But with so many programs,
techniques and advice to choose from it's easy
to be overwhelmed.
(00:21):
Robin with more than 25 years of experience
as a nurse practitioner, and registered diet offers
help and hope for everyone. Families,
children,
and adults.
Along with veteran talk show host and good
friend, Jordan Rich,
Robin invites you to learn much more right
here, on the N npr
(00:44):
podcast.
Welcome back to the N npr podcast. Today
we are very lucky to have doctor Jim
Green on with us today. Welcome. Thank you.
Good to be with you ron. Yeah. So
I'm gonna read your bio.
A pioneer in the field of functional and
integrative medicine, board certified child and adult psychiatrist,
(01:05):
James Green,
has treated patients since 19 88. After receiving
his medical degree in completing his psychiatry residency
at George Washington University
Doctor Green completed a fellowship in child and
adolescent psychiatry at Johns Hopkins medical school. He
currently serves a the chief Medical officer at
Walden behavioral care denim mass. Doctor Green has
(01:26):
lecture internationally on the scientific evidence for nutritional
interventions in psychiatry and Mental, illness. He is
the author of 7 books, including answers to
An,
finally focused the breakthrough natural treatment plan for
Adhd and his more recent book functional and
integrative medicine for anti
withdrawal, which was recently released, Doctor Green was
(01:48):
ind into the ortho molecular hall of fame
in 20 17 by the international Society of
Ortho molecular medicine.
Is the founder of psychiatry redefined an educational
platform dedicated to the transformation of psychiatry, which
offers online courses
educational webinars and fellowship ships for professionals. And
I'm gonna say these websites now, and then
(02:09):
I'll say them again. You can find everything
about doctor Green, at WWW
dot psychiatry read redefine dot org
or WWW
dot James green
GREENBLATDMD
dot com. I'm so glad you're here. Thank
you. Yeah. Very nice to be with you
again. Yeah. I like to tell how we
(02:31):
met I heard you speak at a Meta
conference
in... I don't even know maybe 20 12
something along time... I don't maybe you could
look, think about when you presented there, and
I was, like, very in awe.
And I thought I need to learn more
from this person.
And then I, kind of, I think begged
you for a job at Walden. Thank you
(02:53):
Instead. Will you let me work with you
so I can learn more, and it was
amazing, and I I learned so much, and
you have...
1 of the the things I like to
do on this podcast is is have people
in the field of eating disorders, but also
have people who are entrepreneurs in the field,
and you are such an amazing entrepreneur
with all the things that you've developed with
(03:15):
psychiatry redefined. And so that's huge to me
so to kinda of be able to pick
your brain about all those things. Great. Yeah.
No. I I came into the field of
eating disorders kinda by accident
about 25 years ago. And this was
before walled in, it was a community hospital
walt in Hospital I was cheapest psychiatry, and
we just had a 6 bed eating disorder
(03:36):
unit.
So it wasn't by choice, and it was
just getting exposed
25 years ago to the field and the
current treatment models.
That something just didn't make sense to me.
Mh. And since then trying to sort it
out.
And I remember Walt.
Like I was working up here back in
the day. So I remember that. What I
(03:56):
really wanna focus on today, I want you
to be able to share with folks little
some of the upcoming coursework. You have a
fellowship starting in July. Can you speak to
that a bit? Sure. My energies have been
devoted, you know, over the past 5 years.
To training clinicians. So, psych nurse, practitioners, psychiatrists,
natural breath diet,
(04:17):
anyone that's interested in learning
a model of treating mental health
based in these concepts of nutritional site and
metabolic site,
a more holistic approach,
And so we have short courses,
and then we have a year long fellowship,
but we take people through
the
(04:38):
training of how to integrate this into practice.
Everyone that I've been working with recently
says the same thing. We didn't get this
in school.
Nobody he learns about nutrition and mental health.
Now he learns about
metabolic,
insulin resistance and how it affects. Mh brain
function. So we're really kinda holding hands helping
people integrate this material into clinical practice. You
(05:00):
also very much specialize and we talked about
it in regard to 1 of your books
in Adhd. And I'd love to hear from
you the... I guess the first question I
have is are are females
actually diagnosed later than males. This is a
statistic that I hear over and over and
over, and I think in my own clinical
practice, I definitely see women
(05:22):
who, you know, definitely have
Adhd without question and yet had never been
diagnosed.
So what are your thoughts on that statistic?
Yeah. I'm not as up on the research
last few years, but clinically,
absolutely. I've haven't seen it for for 30
years. So was a child just, you know,
most of what I did 30 years ago
was Adhd set up Adhd clinics.
(05:45):
So that is how I got my start
in kinda looking at nutrition and mental hell.
And what happens,
the the bad news is women tend to
be smarter,
and they tend to not have the hyper
activity and in imp.
Yeah. So they're the attention problems,
And since
many of these young girls are are smart
(06:06):
enough to do fine in school,
they're not picked up.
And
and then in middle school, some problems,
but I've seen so many kids fall apart
in high school.
Because of
the profound in attention, poor persistent of effort
that interferes with their
(06:28):
ability to achieve up to the potential.
And then, you know, the the other piece
to that is we also see a high
correlation with eating disorder is Right. And these,
young women with Adhd. So what would you
say are some of the pearls in terms
and this is a short question for such
a big topic because you do a whole
course on this in your psychiatry redefined
(06:52):
you know, Institute. But what are some of
the Pearls
nutritional to treating
Adhd?
Sure. I mean, the whole... Fun purpose of
our program is to say that everyone's different.
It's hard to come up with protocols.
But I think,
for
Adhd, the research and my clinic experience
has demonstrated that almost every child, adult, male
(07:15):
and female,
deficient in magnesium.
A 1 clinical pearl is without testing a
magnesium is a micron nutrient that I would
recommend for everyone. Yeah. I believe there has
to be some...
Genetic
component to this
because it's not necessarily dietary
related, be on the healthiest diet,
(07:35):
and still benefit from magnesium. So magnesium is
1 of the most
common nutrient deficiencies.
The other kind of,
overarching
thing that we could say for everyone is
some,
you know, the less
processed foods
sugar,
the better. I mean the research is quite
(07:56):
stunning. Mh. The amount of sugar sweetened and
beverages and processed foods,
the rates just go up pretty
dramatically.
And as parents and clinicians, we're not gonna
have everybody eating this, you know, ideal diet.
So I think the simplest intervention is, helping
people,
just put back more protein.
(08:16):
Yeah. To minimize that... Sugar. And modeling. Right?
Parental modeling.
Absolutely of of what we want our kids
to to try to think about... What about
Omega threes? III
This is a topic that's a great interest
to me.
And so how do you see that in
terms of any kind of an Adhd crossover
of treatment. Yeah. I mean, I think that
(08:38):
would be kind of third on my list
as likely, but not everyone. So Mh. You
know, the research is pretty good.
Yeah
but great. Because there are gonna be Adhd
kids that are eating adequate fish and have
Yeah. Adequate it'll omega a 3 when we
test. Mh. But I would say if we
were taking our educated guesses,
both clinically and the research
(09:00):
that
the essential fatty acids are usually deficient.
I think there's just as good research,
looking at not just the omega threes, but
the essential omega 6 is, Mh. Like P
oil as well as omega 3. So all
the earliest studies had
combination products. So that's typically my recommendation.
(09:22):
Is providing the essential omega threes and the
Omega sixes. I find it very interesting because
metabolically, the omega six's are shifted it when
we utilize them in the brain? Correct? So,
like, where do they go to help us
versus the omega 3? What's the difference then?
(09:42):
Yeah. They... Their precursor is to, you know,
hundreds of messengers.
And clearly, a lot of the...
You know, seed oils and the baked vegetable
oils that we're using are very high
and that, omega 6 is,
But there's still...
People get confused, but there's still what we
call essential omega 6 is the body can't
(10:04):
do without. Right. And,
just like omega threes.
And
so I have seen
problems with people just taking high dose omega
threes,
people taking 6 or 10 grams
and That's a lot. Yeah. And then the
omega sixes is. It's like a seesaw. The
omega 6
it down and and I see depression and
(10:26):
other problems.
So what I'm referring to is just
the,
the Gl and the omega sixes that are
Yep. In evening p oil, a small amount
with the omega threes,
have been,
according to some of the better research, a
little more helpful,
for Adhd. So I don't want... Thank you
(10:48):
for that. I don't wanna get 2 into
specific eating disorder, like, 1 versus the other,
but I was just at... The Meta conference
a while back, I was listening to Wendy
Oliver Pi who quoted you, and I would
love to read her quote because I thought
that was very cool.
And she was talking about Adhd and she
wrote, or she had a slide that had
(11:10):
this quote from you, there appears to be
a significant
overlap in terms of involved
neural circuitry,
both Adhd and Demons straight abnormalities and reward
and response
inhibition
in addition to emotional processing and regulation.
And so just I guess briefly because we
(11:31):
could talk for so many hours.
You know, in terms of that
response
inhibition,
and treating that, helping a person regulate and
regulate their emotional processing
based on what
how you practice and how you've learned and
how you're teaching other clinicians. It's really the
the crossover of treating nutritional deficiencies, Right? Whether
(11:55):
that be supplemental or nutritional with food?
And then
how much would you say the cycle farm
psycho pharmacology really comes into that. Yeah. I
mean, I think the overarching
issue for me and we're we're... Disagree with
most of the eating disorder community is... I'm
not afraid to use the word food addiction.
You know, not everyone with binge eating disorder,
(12:17):
So has food addiction. But there's a subset
that does.
And by not acknowledging that, I just find
it a tremendous to disservice
to patients that are really struggling. Mh.
And too much of the sort community just
kinda of puts it into
this kind of behavioral
treatment program. So if we understand that,
(12:40):
addiction,
whether it's alcohol or or certain food, and
it's not food. It's not broccoli or rice.
It is
the Msg and the chemicals that refined sugar
or all the other components that we're eating
So food addiction might not be the best
term.
But so when we think of it that
way, my job is to relieve that suffering.
(13:03):
And, I think,
I guess I could say this, you know,
Gl 1, you know,
revolution.
As some
both good and bad
consequences, but 1 thing from me me at
least it has and validated what I've been
trying to say for 30 years is that
often oftentimes cheating is biologically
driven. Mh. And that's what these medicines have
(13:25):
hip people realize. So the punchline for me,
to answer your question, I would do whatever
it takes
to help someone
regulate
this out of control appetite. Often oftentimes we
can do with nutrients with amino acids,
but sometimes we need medicines.
And
once we can get that kinda appetite under
(13:45):
control,
then all the cognitive behavioral therapy
and mindful eating and all the other tools
that are
we we know my help is just better
utilized. Let's talk about the Gl ones for
a sec 2 around
noise.
So I don't prescribe them, but I share
patients with other clinicians who do prescribe them,
(14:07):
and it's this is the case by case
basis an individualized approach. 1 of the common
themes is the noise goes away.
And to your point,
if the noise goes away, then
these other pieces can actually be
looked at and treated and
helping that person have
(14:27):
the full life they're looking for.
Absolutely.
And,
I don't prescribe Gl ones either.
But I I think they have a a
important role,
for diabetes and and maybe for, binge eating,
a new review article just came out.
But just as you described,
(14:48):
when the biology and the brain changes.
Then
we can and make a huge difference for
our patients.
And, you know, I'm actually giving a talk
Monday night,
it'll be recorded if this comes out and
after, just a a webinar
on amino acid therapy.
To that ged.
(15:08):
And and the hormone Gl 1 is is
a
is a peptide made up of 30 amino
acids.
So if we don't have those adequate,
you know, essential amino acids aren't body. We're
not gonna be able to build our own
and a hormones that regulate
appetite. So there is a kind of nutritional
approach
(15:29):
that can support
in the same biological way these meds can.
Mh.
I really appreciate how you put that.
That
that makes a lot of sense.
1 of the questions I like to ask
because you are an entrepreneur. So I kind
of, I feel like I can answer this
myself in a way is where you see
the field going versus where it's going?
(15:52):
You've been chief Medical officer,
right, held
bigger positions at Walden behavioral care. You've had
a private practice. Now you're educating other clinicians.
Is this where you see the field really
going? Like, it is for you in your
career? In terms of eating disorders per s,
where do you see the field going versus
(16:14):
where it's going? And are they... Are they
the same and... Or are they different? Well,
I think they're different. I was recently at
the American Psychiatric
Association
conference?
Are 12000
psychiatrists just from around the world
with every drug company,
you know, having exhibit booths. And I was
just struck by how many people were interested
(16:36):
in a nutritional site and and the work
that we're doing.
So
I think a
psychiatry mental health, our psycho,
particularly our nurse practitioners are just understanding that
there's a path.
Beyond psycho... Just psycho farm. Yeah. None of
us have given up our prescription paths, but
there's so much as you know, we can
(16:57):
do.
I have to say the eating disorder of
community lags far behind.
Mh. And be this disorder of community.
It's still resistant to nutritional supplements
is resistant to looking
a deeper,
and
seeing what's right in front of them, which
are very malnourished
(17:18):
patients regardless of a body size. Right. Complete,
These use profound micron nutrient deficiencies
that
I think it's really sad that our community
has really lost sight of that.
Do you feel like you with your Institute?
I mean, you're changing that?
I'm trying as what are people that are...
(17:40):
This year, we're actually, we're gonna have a
a binge eating disorder intensive, So 6 weeks
going through all the material, so starting in
the summer.
And I will do a an
training. Again, trying to help people appreciate.
Micron nutrient deficiencies. Mh.
And an Ocd training in the fall. So
(18:00):
we are trying to educate
those that that want more information,
I really like how you're doing that too
just from a business standpoint for clinicians because
you have the the longer fellowship.
You have these webinars you're doing. But you
also have these shorter
sections of ways that folks can learn
(18:20):
very specific to me with their populations, but
also from a time
perspective. It's it's maybe more doable for a
clinician.
Yeah. No. That... That's been my thinking. And...
Not only do we have the courses, like,
for the binge eating
program, but it'll be, you know, 6 hours
of recorded?
But then supervision. So people can ask the
(18:42):
question, You know, what do you mean about
by amino acid therapy? Right. You know, How
do we test for
this. So really trying to make it practical
where people can utilize this material their practice
is to help more patients.
What do you say? I wanna go back
to Adhd for a second. When you see
a new patient
who
(19:02):
has this diagnosis?
Parents have been avoiding
really any kind of treatment. How do you
approach
parents who are very
re
about anything
in terms of treatment.
And how would you how would you recommend
to other clinicians that they might
(19:23):
help parents. These are parents say of minor
children right under 18,
become comfortable
with
a crossover,
you know, the multi level treatment
that a person,
a younger person with this diagnosis, it could
be anybody, but this is just are just
parents. How do you how do you approach
them
(19:43):
and try to get them on board. Sure.
I think the most important is is education.
And if we start by helping... These Parents
understand this is a neuro
illness. It's not low power is not bad
behavior,
and as nobody's fault. So if we... Say
that 1 more time. Say the 1 more
time for everybody because people really don't understand
that. Yeah. No. The most important thing I
(20:05):
can share with clinicians or parents.
Is if we have a diagnosed of Adhd,
then we're helping,
everyone understand is a neuro
disorder
don't know all the details, but we have
a pretty good understanding of
receptors and neurotransmitters.
And that the symptoms, the imp,
(20:26):
the over activity and the poor attention, and
and
for motivation, it... These are biologically
driven
symptoms. So if we can help parents understand
that and
get rid of the blame game.
Certainly get rid of the... This is bad
behavior. They're doing it on purse purpose, just
upset us.
(20:47):
And then I just try to outline,
we need a biological
approach,
and and we can do it a number
of different ways, and there... Some families that
are just against medications and we say, well,
we can dig deeper and look at
nutrition and testing
that there might be
elevations of lead or copper, that might be
(21:07):
deficiencies of magnesium.
So we could do that for 3 months.
And support the parents in education.
And if a child is suffering and is
not doing well at school and poor social
relationships. Then my job is to help convince
them that there are medications that could help.
Mh. And I think they'll trust you more
(21:27):
if you can appreciate.
And work with them about, you know, what
their preferences are. Some people are are desperate,
and they come in, the child needs medicine
and the parents, appreciate the role of medicine.
And and there's the place for that in
some of these young kids that are really
suffering and not living up to their certainly
academic potential.
(21:48):
What do you think about this, the new
medication Quell? Just curious. Yeah. I mean, I
would just say interesting and then... I haven't
seen great results. I haven't prescribed it, but
I've seen some often on it. I I
just think the stimulant tour.
So well, so simple and so safe.
That with an integrative nutritional approach,
(22:10):
often we don't need more medications. Yeah. I
think it's also important for parents to hear
I don't know if you say this, but
this is this statistic that I've read and
seen in research that most folks who do
take stimulants for
Adhd, do not then they're not addicted.
Right? There's this fear, I think that parents
(22:31):
have about addiction around stimulants.
Yeah. Absolutely not. I mean, many kids can
get off it. And
I think the research that I quote all
the time is the kids that took the
medications were the ones that had...
Less addiction. Yeah. In in their future. Because
they were treated it. Right. They did okay
in school. They did okay in life, and
they didn't have to hang out in the
(22:51):
back of the school
you know, getting high. Mh. Because they were
failing. Mh. Yeah. So... Yeah.
Do you feel like there's still a role
for something like an ad?
In treatment. Do you still use that ever?
No. It hasn't been a a favorite of
mine. I I've sent... You know, this because
success is some limited. I mean, it's occasional,
it's hard to predict.
(23:13):
So, you know, I still use gu.
Mh. And I I'd still use the stimulants,
and I would say, with the nutritional approach,
looking at everything from
genetic testing to micron
deficiencies,
that's pretty much the the bulk of what
my practice has been for many years.
(23:33):
I spoke to Daniel Doubt the other day?
Up from Gen,
because any person that I see who does
the gen genetic testing, I'll do a call
with 1 of the clinicians there. I know
he up spoke to you on a webinar
or something recently.
And we were talking about the
differentiation between
some people being more responsive to meth
(23:56):
versus some peep people being more responsive to
amp.
And I wonder if you see that in
practice.
Yeah. I see it all the time, sometimes,
the the genetic. Testing can guide us. Sometimes
it's just kinda clinical experience, but
absolutely,
you know,
to me, I've seen a big difference, testing
(24:17):
between the in and the meth.
Mh.
So what's on horizon for you your... Kidding
lots of clinicians, will you be writing another
book? Are you writing another book? Tell us,
tell us what to look for? Well, well,
great question. Yeah. Actually just
completed a a theoretical deal not signed, but
(24:38):
I'm gonna be writing a book on a
functional medicine for depression.
Nice.
And then the finely focused book,
we just agreed to do a second edition.
So to update the Adhd material, so it's
relevant for 20 24
and beyond. That was first written in 20
17.
So my focus this year will be on
(24:58):
finishing a book on
functional medicine for depression,
It is a... A number 1 disability in
the globe,
you know, hundreds of millions of people suffering,
and our treatment model.
Is just barely better than, you know, placebo,
50 percent. So I think a functional medicine
approach and really kinda augment our model. Mh.
(25:20):
That's my priority this year.
And you have these
different trainings coming up right this summer for
binge eating disorder. I think you said An
and Ocd? Yes. These are about 5
to 6 weeks of training.
Or And then the fellowship
starts again in July. Right. That's our. It's
(25:41):
actually a 2 year program now. 1 year
of
kind of
guided
supervision and mentorship. And I wanna just review
again so folks can find you around the
globe. So
Doctor James Green can be found at
psychiatry
redefine dot org
or James green,
GREENBLATTMD
(26:04):
dot com. My last question I have for
you is would you take your own advice?
Professionally or personally, and you can say no.
But I'm just curious, would you take your
own advice and if you would, What would
it be?
Well, certainly, absolutely, I I think when we
were all young
that
there were times probably I was too busy
(26:25):
to... You know, Do all the things we
know we should do. But certainly,
at this point, treating in a patience and
understanding the role of
you know,
connections and diets and help and sleep and
lifestyle and stress,
absolutely. I would be very
(26:46):
easily kind of appreciate the role of nutrition
and now.
Way back in the in the early days.
I wrote a paper in college on,
you know, a nutrition and brain function. There
was a group of us.
I I think we would would be... In
the 19 seventies, there was a student group
we were wrote how to eat your way
over a 4.
(27:07):
I love that title. Nutrition, nutrition
and brain hall. Okay. So you have taken
your own advice then professionally, really?
Absolutely. Yes. Yeah. Thank you so much, Jim
for your time today. I really appreciate it.
I I really do learn from you every
time I get to talk to you. So
thank you. Thank you for. No. Thanks for
spreading the word and doing the work that
(27:28):
you're doing.
Thank you for joining us for the N
npr
podcast with Robin K. We invite you to
subscribe, download, rate and review us and share
this valuable podcast with Friends and family.
Help and hope is found here. For more,
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(27:50):
That's R0BYNKIEVIT
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