Integrative Psychiatry with Dr. Robert Hedaya: Rational Wellness Podcast 333

View the Show Notes For This Episode

Dr. Robert Hedaya discusses Integrative Psychiatry with Dr. Ben Weitz.

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Podcast Highlights

1:38  Dr. Hedaya noted that from his time in medical school he was always oriented towards getting to the root cause of things. After writing his first book, he was on the edge of chronic fatigue and he dove into the metabolic medicine approach of Dr. Jeffrey Bland, which later was changed to Functional Medicine. Dr. Hedaya was a neuropharmacologist trained in cognitive behavioral therapy and after bringing Functional Medicine into the mix he found that he was no longer doing this medication merry-go-round and most of his patients were now getting better. Dr. Hedaya explained that after writing his second book, he hired a statistician to assess the patients he had treated for treatment-resistant depression.  All 23 of these patients when they started had a mean Beck Depression inventory of 34, which is in the severe range, and by about 10 months everyone was normalized with only one change in medication but also adding the Functional Medicine approach. 

4:18  Insights into a Functional Medicine approach to psychiatry.  The key to using a Functional Medicine approach is to be a medical detective and to also understand that psychiatric problems are not primarily psychological, but more related to physiology and infections and hormonal problems and genetics and epigenetics and gastrointestinal things, etc..  The mental realm is directly part of the physical realm.  If your physical health is lacking, if you're lacking in nutrients, if you're having toxins and infections and other things that are affecting your physiology, that's also going to affect your mind.  Dr. Hedaya recalled his first patient from 1984 who was a 50 yr old woman with panic disorders and she did not have a great marriage and had bunch of things going on, but she didn't get better despite psychotherapy and medications.  He determined that she had a vitamin B12 deficiency and after her first injection, her panic went away and that's when he realized how powerful the Functional Medicine model could be.  When assessing B12 status, if your serum B12 is low normal, you probably have a B12 deficiency. But you can also look at the size of the red blood cells, the MCV, on the CBC. If you are B12 deficient, your red blood cells will get larger because they hang around longer--macrocytic anemia.   If you are iron deficient, your red blood cells will be smaller--microcytic anemia.   But you could have normal size red blood cells if you have both iron and B12 deficiency, because they will offset the effects on the red blood cell size.  We should also look at methylmalonic acid (MMC) and homocysteine as measures of B12 status, though MMC only accounts for 17% of B12 status.  You also need to look at medications that interfere with B12 status and if they are older they tend not to absorb as much B12 because of reduced HCL production.

10:57  Iron.  

11:29  Other nutrients, incl fish oil, vit D, zinc, and protein.  

12:12  Thyroid adrenal axis.  

15:30  Genetics, includeing NR3C1, FKBP5, CRH receptor 1 and 2, CRH binding protein, these control proteins that control the effective steroids inside your cell at the level of the nucleus.  

18:18  Gut Health.  

25:32  Ketogenic diet.  

30:24  HYLANE technology.  

Dr. Robert Hedaya is an MD/Psychiatrist who is board certified by the American Board of Psychiatry and Neurology and he also teaches Functional Medicine approaches to psychiatric disorders with the Institute of Functional Medicine.  He is also a Clinical Professor of Psychiatry at Georgetown University Medical Center.  He wrote a number of books, including Understanding Biological Psychiatry, The Anti-depressant Survival Program, and Depression: Advancing the Treatment Paradigm.  He treats patients with psychiatric disorders with a Functional Medicine approach, pharmaceuticals when indicated, and he has now pioneered the use of the HYLANE program, which includes Hyperbaric Oxygen, EEG guided laser, and neural exercises.  His website is WholePsychiatry.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.