Keto and Carnivore： Schizophrenia, Depression, Cancer ｜ Dr. Chris Palmer ｜ EP 422 (H_z3ncVYAw8)

https://youtubetranscript.com/?v=H_z3ncVYAw8

Hello everyone. I’m pleased to announce my new tour for 2024. Beginning in early February and running through June, Tammy and I and an assortment of special guests are going to visit 51 cities in the U.S. You can find out more information about this on my website jordanbpeterson.com as well as accessing all relevant ticketing information. I’m going to use the tour to walk through some of the ideas I’ve been working on. My forthcoming book out November 2024, We Who Wrestle with God. I’m looking forward to this. I’m thrilled to be able to do it again and I’ll be pleased to see all of you again soon. Bye-bye. Every culture on earth has used fasting as a healing intervention or a religious intervention. Hippocrates knew about this. Jesus knew about this. So this has been known for millennia that fasting can help. It is a physiological way to induce healing and you basically are tapping into the body’s innate ability to heal and repair itself. Hello everyone. I’m speaking today with Dr. Chris Palmer. He’s associated with the Harvard Medical School and with McLean Hospital, which is perhaps the world’s preeminent psychiatric hospital. We talk today about material associated, for example, with his book, a 2022 book called Brain Energy. Dr. Palmer has been pursuing the hypothesis that many mental disorders, especially the really severe mental disorders, schizophrenia, bipolar disorder, major depression, intractable depression, with no apparent environmental cause, let’s say, or psychological cause, might be associated with metabolic disorder mediated primarily by mitochondrial dysfunction. The mitochondria are basically the energy factories in every cell and that’s not all they do. Mitochondrial disorder therefore is a very, very serious problem. He’s been experimenting with ketogenic diet, Ken in some sense to the diet that my daughter has been promoting, the lion diet, making the case that use of such diets can not only reduce the effect of potential toxins on mitochondrial function but also increase mitochondrial metabolism and also help the body heal by putting it into a state known as a autophagy or mitophagy, which are states where the body is actually taking itself apart as a consequence of food deprivation and then rebuilding itself. Anyways, he makes the case, we’ll discuss the probability that this kind of hypothesizing has gone beyond the merely anecdotal to the point where there is a tremendous amount of research supporting the proposition that dietary factors play a major role in the genesis of such severe mental disorders and not only mental disorders, also physical disorders like obesity, heart disease, cancer, diabetes, you know, the common enemies of mankind. And so we’re going to discuss that in detail. Thank you for joining us. Dr. Palmer, let’s start out at the level of conceptualization. In your 2022 book, correct me if I get any of this wrong because I don’t want to put words in your mouth, you’re concentrating at least on the relationship between I would say brain dysfunction, biological dysfunction, metabolic dysfunction, and what we generally think of as mental disorders. And so the typical more abstract psychological conceptualization would be that a mental disorder, something associated with psychopathology and undue suffering, let’s say, with dysfunction in the social environment and so forth might be a consequence of faulty beliefs and perceptions. And so they can get bent to the point where they’re indistinguishable from delusions. And then also skill deficits, which is often what behaviorists remediate. And it’s obvious that a skill deficit in social ability, for example, isn’t equivalent to a metabolic disorder. But let me start by asking you how you lay out your conceptualization of metabolic disorder and what implications you think that has for the diagnosis and further understanding and treatment of so-called mental disorders. You know, it’s a complicated situation as you even just began to hint at. And, you know, maybe one easy way to outline my conceptualization is to think about mental disorders. And so what I’m trying to say is that the only way to outline my conceptualization is that there are mental states and there are mental disorders. So all humans will suffer. All humans will have anxiety at some point or another in their life. All humans will get tragic loss or humiliation and shame. And those are not brain disorders as far as I’m concerned. That is the normal state of being a human being. And as you alluded to, depending on your upbringing and your experiences, you might learn maladaptive themes or maladaptive lessons in life. People aren’t trustworthy. You can’t trust anybody and you go through life that way. And that can actually have very serious consequences for people. But I don’t think those people have brain disorders. The reason they believe what they believe, the way that that happened is all obvious once you understand the person’s full history. And so there are myriad ways in which humans can suffer and develop maladaptive patterns that do not include brain disorders. And psychotherapy can be helpful and just being human and all of the life skills that you talk about apply to those people. And yet there are other people who have brain disorders. Their brains are malfunctioning. They have anxiety or panic for no reason. They have crippling OCD for no clear reason. They have crippling, unrelenting depression for no clear reason. They have hallucinations, delusions, manic episodes and other types of symptoms. And it is largely believed in the psychiatric field that these people do in fact have brain disorders and that their brains are malfunctioning. And at the end of the day, what I am arguing is that there is in fact a central theme to these malfunctioning brain symptoms. And they revolve around metabolism. And that if we take this global picture and understand that these brain conditions are actually metabolic in nature, number one, it can help us better understand how all of the risk factors can come together to result in mental disorders or mental illness. But much more importantly, it gives us clear, actionable treatments that we typically do not use today. And they span a wide variety of different treatment strategies, but they include things like changes in diet, changes in exercise, looking for hormone or vitamin deficiencies, thinking more kind of in a more sophisticated way about substance use and thinking in a much more sophisticated way about the medications that we prescribe for psychiatric conditions. Because some of them can improve brain metabolism, but we know that some of them are actually harmful to metabolism. Let me outline a diagnostic approach to you with regards to the differential diagnosis of depression. And I’ve thought about this a lot. So tell me what you think and then we’ll turn to a discussion of the list of contributing factors to physiological brain dysfunction or illness. And we can tie those together. Okay, so one of the things I noticed as a clinician, and I think that this is key to solving the mystery of perhaps, perhaps of differential response to serotonin reuptake inhibitors and other antidepressants. Now, I don’t think it’s the only key, but I think it’s an important one. I don’t think it’s one that’s being attended to enough. So I noticed in my practice that there were two broad classes of people with depression. Okay, so we could define depression first for everybody watching and listening. So depression looks like a condition analogous to an excess of pain. It’s associated with grief and shame and guilt. It’s characterized by a decrease in positive motivation. So less enthusiasm, less curiosity, less hope, often hopelessness per se, and a proliferation of negative emotion. So and those are separate biochemical systems to some degree. So if you’re really depressed, you have no positive emotion, and you have way too much negative emotion. And then that manifests itself, well, it can manifest itself as a virtual inability to move, even no motivation, and often an overwhelming sense of doom and a proclivity even towards suicide. So that’s the depressive realm. It’s a psychogenic pain condition, and it differs from anxiety, even in its, although they overlap. Now, I had clients who were in that condition. But then imagine that those broke into two classes. I have the odd client who, by all appearances, by all standards of multi-dimensional assessment, had fine lives. So these would be people who were reasonably healthy, apart from the depression, let’s say, who had a functioning marriage, who had friends that they liked, and a marriage that they liked, even though the depression might have been twisting their perception of that. So for example, they may have thought that they were now so useless and contemptible that no one like their wife could possibly love them, and that they were a burden to their family. But they still had tight family relationships. They often had careers that were well-developed and going fine. They were about as educated as you could expect. They didn’t necessarily have any substance use disorders. They did productive things outside of work, but they were profoundly depressed. Okay, so that’s one category. Now, the other category of person wasn’t like that at all. They had no relationships. They had no stable marriage. They had no friends. They had no job. Their educational history was fragmented at best. They had no plan for the future. They didn’t have a life. Now, both of them were miserable, and maybe even in an equivalent manner. But the first group of people with a functional life was very much unlike the second group. Now, what I noticed, and I’ve never found any literature directly pertaining to this. Maybe you know of some. I found in my practice that if I recommended to those clients, the ones who had a functional life, that they tried antidepressant, it was often likely to have relatively miraculous effects. Whereas the people in the second category, the antidepressant, could maybe help ameliorate the worst of their suicidal ideation and possibly tilt them a little bit more in the direction of positive motivation. But generally speaking, not a very effective treatment. Now, and logically, because if all those things were absent, the mere offering of a biochemical treatment wasn’t going to, you know, provide someone with no partner with a highly functional marriage. So, and I think in that differentiation, we can also see a distinction between the biological, and that would be what was hypothetically plaguing the people with functional lives, and the conceptual, because it was the absence of the ability to go about forming all those relationships, say, and pursue all those pathways in the latter case. So the first thing I’d like to ask you is, for your general thoughts about that diagnostic approach to distinguishing between the biological and the so-called psychological, and then, well, and then how you go about doing that, because you already pointed out that you accept the distinction between biological mental illness, let’s say, and, well, conceptual disarray, something like that, or lack of skills. Yeah, so I think you just did a great job of articulating that framework that I just outlined, that there are some people who have brain disorders. Their brains are doing things that don’t make sense. They don’t make common sense. The first person that you described, or that first category of people you described, it doesn’t make sense that that person is depressed. They’ve got a good life. Everything’s going well for them, and they will often even say that. They will say, I don’t know what’s wrong with me, doctor. I don’t know what’s wrong with me. My wife loves me. My kids love me. I have a good job. We finally saved up enough money to get that vacation home that we wanted. I just got a promotion at work. By all intents and purposes, I should be happy, and I am miserable, and I feel like a burden, and I don’t know what’s wrong with me. Please help me. I would argue that person has, very likely, has a brain disorder. The pathways that are hardwired in the brain to trigger the depression response are malfunctioning. They are misfiring. They are causing the sensations and all of the experiences and perceptions of depression when they shouldn’t be. And here’s an easy analogy. All humans will experience pain. Pain is a normal human experience. If we injure ourselves, we will feel pain. If we get surgery, we may have prolonged and extensive pain. Those are not disorders. They cause suffering, and people often want help for that, and people often want treatment. They might even take pills for it, or they might need physical therapy or something else. So it’s not that we don’t treat pain. It’s not that they don’t have a pain disorder. And then there are other people who have pain disorders. Their pain system is malfunctioning and causing the sensation of pain when there’s no clear good reason for pain. So that gives us a framework of normal and extreme. If you get surgery, you may have extreme pain, but those aren’t disorders. And then somebody who’s got a pain disorder, where they have chronic unrelenting pain for no good reason. Their pain system is malfunctioning. And so that first category of person, I would say, their brain, the networks that cause all of the different experiences of depression, those networks are malfunctioning. They are either overactive or underactive, depending on what symptoms we’re looking at. But they’ve got a malfunctioning brain that is causing the experience of depression. The second category that you mentioned, the person whose life is just a tragic mess. They’ve never had anything good going for them. They don’t know how to create a good life. They don’t know how to take care of themselves, how to have good positive relationships. Maybe they have no purpose in life. Those people will, in fact, experience depression. And if they don’t experience depression, that in and of itself is a disorder. Anybody in that circumstance should, in fact, be depressed. The human brain is hardwired to make that person depressed, because the human brain is trying to get that person to get a life, to integrate themselves into society so that their tribe, so that other humans actually accept them, integrate them into the culture or the tribe or whatever we want to think about it. And that creates safety, that we as humans are supposed to be connected with others. And that means that we are supposed to be connected not only in terms of loving relationships or work relationships, but we’ve got responsibilities. We’ve got responsibilities to ourselves and to others. And if we’re not participating in that culture, in that society, that means we are an outcast. We are being shunned. We aren’t integrating. There’s something wrong. And those people will… And that’s a danger. It’s a danger. Well, so one of the things are… Let me ask you what you think about this. So, you know, there’s a relationship between the degree to which a given brain is likely to produce serotonin and the relative social status of that person. Okay, so… And this is germane biologically to the problem that you just described, because it turns out if serotonin modulates the magnitude of pain-like responses to negative circumstances, to stress, let’s say, and if you’re low status, which means if you’re low status, you’re more likely to have an exaggerated response to stress. And that can kill you across time. That’s very well documented. Very high relationship between relative social status and risk for mortality. But the reason for that, and you’re pointing to this because someone might think, well, you know, your claim that you need to be integrated within a social community is just an arbitrary claim. There’s nothing based in reality about that. It’s just a supposition of normality, and there’s no reason to assume that it’s related to mental health. But the reason that’s erroneous is because you are much more likely to have opportunity and to have security of the genuine sort. So that’s the kind of security that can save your life if you have a very well-developed and functional social network, and you’re very well regarded and respected and integrated within that. And as you it intimated, we do have systems that perceive that and that causes pain in the absence of that, and that is definitely a contributing factor to depression. That’s not some arbitrary moral presupposition. It’s hardwired into the fact that we are incredibly interdependent and social creatures. And that’s so much so. This is something for everyone to think about, too. We’re so wired to need that social harmony and interaction that we can even punish the most vicious and psychopathic anti-social criminals by putting them in solitary isolation. So even those guys can’t do it alone. Okay, so depression can be a valid marker of the inability to be integrated, right? And it can become counterproductive even under those circumstances. But the condition in itself, just like the condition of pain, isn’t an indication of pathology. So, okay, so let’s talk about differential diagnosis. So, okay, so we’ve already agreed, as far as I can see, that there’s a difference between a physiological disorder and a more abstract or mental disorder. Now, the other thing I tried to do in my practice was to rule out the physiological before proceeding with the psychological. Okay, now you pointed to a bunch of potential contributors to the physiological. So let me list those, and then maybe you can tell me if I missed any, if you dispute any, and how you go about that diagnosis. So here’s some things that can make you mentally ill, apart from the contents of your thought or perceptions. We know that depression is associated with, often associated with markers of excess immunological activity. So if you’re in a cytokine storm, you can get depressed. There’s all sorts of dietary reasons that we could delve into. There’s all sorts of illnesses that can produce depression as a side effect. There’s an issue of adverse response to medication. It might be that you’re in bad physical shape and need to exercise more, and some people are more prone to depression in the absence of exercise. There’s a huge potential complication of toxin exposure, environmental and otherwise, and then there’s the associated problem. One of the quick pathways to depression, especially if you’re biologically tilted in this direction, is to drink to relative excess three times a week, because then you’re always in alcohol withdrawal. Okay, so another thing that a good diagnostician should do is think, well, this person presents with depression, but maybe they’re ill, and here’s, you know, 10 things we should look at to rule that out. So tell me what you think about that, and how you go about doing that when you’re actually seeing your patients. So I think all of the things that you mentioned are absolutely spot on. I think that they can all play a role in the physiological brain disorder type of depression, that all of those things can result in the brain malfunctioning and producing the experience of depression when, in fact, the person doesn’t have the psychological or social reasons to necessarily be clinically depressed. You know, you mentioned medical diagnoses, I think, and that’s a very broad field, because numerous medical conditions are associated with increased risk for depression, all the way from all of the neurological disorders, epilepsy, Alzheimer’s disease, Huntington’s disease, Parkinson’s disease, to hormone imbalances, hypothyroidism or low thyroid hormone, women’s hormones, a lot of women experience mood changes, mental health symptoms, just around the time of their menstrual periods, they may have significant changes around the time of pregnancy and immediately after pregnancy, and they can have significant changes around the time of menopause, men can experience similar symptoms if they have low testosterone. So there are a wide range of medical conditions that can all result in the exact same symptoms of major depression, and that, in my mind, is very curious, and we in the mental health field just shrug that off, but what it suggests is that all of those things are somehow connecting through some common pathophysiology, and in my mind, that is actually a really important clue to solving the puzzle of mental illness, like what causes mental disorders, what causes this tremendous suffering in millions and millions of people around the world, how can we develop better treatments by recognizing that all of those things must share something in common to produce the exact same constellation of symptoms, that’s actually really useful information, and in my mind, the common thread is that they all impact metabolism and more specifically, these tiny things in our cells called mitochondria. Start off the new year with Balance of Nature Fruits and Veggies. They’re a great way to make sure you’re getting essential nutritional ingredients every single day of the new year. Balance of Nature uses an advanced cold vacuum process that encapsulates fruits and vegetables into whole food supplements without sacrificing their natural antioxidants. The capsules are completely void of additives, fillers, extracts, synthetics, pesticides, or added sugar. The only thing in Balance of Nature’s fruit and veggie capsules are, well, fruits and veggies. Right now, not only will you get 35% off your first order, you’ll now get a free fiber and spice supplement as well. Balance of Nature’s fiber and spice supplement is a revolutionary fiber drink with a unique blend of 12 spices and whole foods. There’s never been an easier way to make sure you’re getting your daily dose of fruits and vegetables. Experience Balance of Nature for yourself today. Go to balanceofnature.com and use promo code JORDAN for 35% off your first order as a preferred customer, plus get a free bottle of fiber and spice. That’s balanceofnature.com, promo code JORDAN for 35% off your first preferred order, plus a free bottle of fiber and spice. Okay, well then, let’s let’s lay that. I would be very interested in hearing much more detail about that. So, you know, because I’ve delved into potential physiological causes for exacerbated pain sensitivity, let’s say, and the entire depressive spectrum of symptoms, but not not precisely on the metabolic front. So, why did you, given the plethora of contributors that we’ve already discussed to the problem of depression and then the broader problem of mental disorder, why did you feel that concentrating on the metabolic, on metabolic dysfunction per se, was the most useful tact to take? And maybe, so let’s do two things. Why don’t you tell us in some real detail what you mean by metabolic disorder all the way down to the mitochondrial level with perhaps an explanation of the function of mitochondria, and then tell us why you think that’s particularly worth worthy of focus, given all the other contributors, maybe as a common final pathway even, given all the other contributors to depression. Yeah, so right now, if you ask the leading psychiatrists and neuroscientists in the world what exactly causes mental illness, and we can stay focused broadly on all of the mental disorders, or we can just hone in on major depression, that first category of depression that we talked about, that somebody, they don’t have a reason to be depressed psychologically or socially, and yet they’re showing all of the signs and symptoms. Like, what is going on? If you ask the leading people, they will say, yeah, it’s just too complicated, nobody can figure it out. What we do know are risk factors, and we talk about this biopsychosocial model of risk factors, and we say that there are biological things, neurotransmitters, hormones, genetics, that play a role, but there are psychological and social things. People can develop mental disorders, like the brain disorder type of thing, from prolonged trauma, or social adversity in childhood, or loneliness and disconnection, and that those things also contribute to mental illness, but exactly how do they come together? Right now, the leading people will say, no one knows, it’s too complicated. The way that I came to metabolism is because I had some really important kind of pieces of information that were quite shocking, that I was actually using dietary strategies, pure serendipity. I did not set out to do anything special, but I was changing people’s diets to help them lose weight, and noticing dramatic improvement in psychotic symptoms, and mood symptoms, and other symptoms. So, okay, so you came at this, you started to understand this, because you started to examine diet, and you were examining diet, why exactly? What was just to help people lose weight? This will take me on a tangent from the question that I’m going to come back to. You asked me a question, and I’m going to come back to it. But this tangent is that I had this patient with schizoaffective disorder. He had been my patient for eight years. Schizoaffective disorder is a cross between schizophrenia and bipolar disorder. This man was tormented and disabled by his illness. He had chronic hallucinations, delusions. He was paranoid. He was convinced that everybody in the world was out to get him. People were laughing at him, spying on him, trying to hurt him. He had tried 17 different medications. None of them helped his symptoms. He had gained a massive amount of weight and asked for my help to lose weight. And I put him on a ketogenic diet to try to help him lose weight. And within two weeks, not only was he starting to lose weight, but I began to notice this powerful anti-depressant effect in him. And the shocking thing that led me ultimately on this path was that about two months in, so it doesn’t happen overnight, but about two months in, he starts spontaneously reporting that his hallucinations and delusions are starting to go away. That man went on to lose over 160 pounds, has kept it off to this day. Seven years later, he was able to do things he hadn’t been able to do since the time of his diagnosis. He was able to go out in public and not be paranoid. He was able to complete a certificate program. He was able to perform improv in front of a live audience. Wow. Wow. He teaches karate. Now, he was able to do things that were all but impossible for him and somebody with his diagnosis. And that, initially, I was just in disbelief. I couldn’t believe what I was saying, and I’m thinking that this can’t be happening. Schizoaffective disorder doesn’t get better, and it certainly doesn’t get better from a change in diet, what on earth is happening. So I initially set out on a journey to understand what on earth is the ketogenic diet doing. And that was quickly led to its use in neurology. So although a lot of people know the ketogenic diet as a fad diet or a weight loss diet, it’s actually a 100-year-old evidence-based treatment for epilepsy. And it can stop seizures even when medications fail to stop seizures. And the reason that’s so important to me as a psychiatrist is because we use epilepsy treatments in psychiatry every day in tens of millions of people. We use pills that were originally designed to stop seizures, and we use them for a wide range of mental disorders, including depression, anxiety, alcoholism, dementia, and schizophrenia, bipolar disorder, and others. And so initially that was a really important connection because I thought, well, maybe that’s why this diet is changing his brain symptoms. Whatever it’s doing to stop seizures, maybe those same processes are also reducing his psychotic symptoms. Like reducing excess neural activity, for example. Because you could imagine that that delusional state is a… I’m not saying this is the case, but you could imagine that it is the case, that it is a consequence, at least in part, of excess neural activity. Now, if you have too much neural activity, you’re going to get the electrical storm that characterizes epilepsy. But you could imagine that a man could be in a psychophysiological, neurophysiological condition where the spread of ideas around the core idea is too rapid and too wide. And a delusion certainly looks like that to some degree, especially a paranoid delusion. You even see that to some degree in depression because in depression, one sad idea will trigger an avalanche of sad ideas. So just a thought with regard to the potential overlap with epilepsy. Okay, so you started looking at the dramatic, as you pointed out, dramatic effects of ketogenic diets on epilepsy treatment and started to think if that, given that that dramatic effect on brain states exists, which is clearly documented, right, and no one disputes it, that there’s no reason to assume that there couldn’t be more subtle but still important effects of dietary transformation. And then you became partly convinced of that as well because of the, I mean, the story you tell about one client, and that’s a ridiculously dramatic story because schizoaffective, personality disorders are notoriously difficult to treat. Schizoaffective disorder is a complete bloody catastrophe because it has all of the aspects of personality disorder that’ll produce social alienation, plus all the intense suffering that characterizes the whole hallucinatory nightmare of delusion. So it’s a very, very serious personality disorder, neuropsychiatric condition, and then you saw this dramatic transformation in this one individual, not only on the weight side, which is dramatic enough and unlikely enough, given that most people never lose their weight, right, they’ll lose it for a time but they gain it back and more. And also the cessation of the symptoms, and also this makes it even more complex because it took two months. This is not an easy thing to discover, right? I mean, the person has to be pretty damn committed to the dietary transformation and also unlikely to cheat in the interim. So, okay, so you encountered those. Let’s return to the metabolic story. And so initially, well, and I want to back up just a little bit and just forgive me, but I want to just correct something that you said. So because I’m talking about schizoaffective disorder, which is really the full-bred cross between schizophrenia and bipolar disorder. Oh, so this is more than the personality disorder? As opposed to the personality disorder, which is schizotypal disorder. So he had- Oh, I see. So it was even more serious. It was even more serious. He basically had full-fledged schizophrenia. Full-fledged psychosis. Full-fledged psychosis. I see. Oh, okay. And so as I went on, you know, initially, I’m starting to use it with other patients and I’m seeing equally transformative and sometimes even more transformative results. So I know I’m on to something, but I also recognize nobody’s going to believe this. Nobody in the medical field is going to believe that a diet could change something as devastating as schizophrenia. So I need to come up with at least a potential mechanism of action. I need to understand enough science to be able to make the case, to be able to report this in the medical literature. And so the great news is that I had two bodies of literature to call on. So there’s an entire body of literature in the neurology field on how on earth does the ketogenic diet stop seizures? And there are all of these known mechanisms of action, including changes in neurotransmitters, changes in the gut microbiome, decreasing inflammation, all of these things. But one thing stuck out at me. It improves mitochondrial function, which basically means it improves brain metabolism. The other body of literature that I had to look at, though, was the schizophrenia literature and the bipolar disorder literature to see, well, what do we know about the neurology, the neuroscience of those disorders, and is there any overlap? And the widely held view is that schizophrenia is just too much dopamine. That’s what schizophrenia is, too much dopamine. But that didn’t sit with this this kind of observation that the ketogenic diet is dramatically reducing symptoms. The dopamine thing didn’t fit in. And so I had to look elsewhere. And I was led to this entire body of literature two decades long now, documenting that mitochondrial problems may in fact be the central root cause of schizophrenia and bipolar disorder. Okay, let me ask you a question there. So, well, the dopamine hypothesis has been around for a very long time, and it is the case. And it’s been a while since I reviewed this. So if there’s anything that I’m saying that’s no longer, that’s out of date, let me know. Part of the evidence for that was that at least with some forms of schizophrenia, you could exacerbate the symptoms with amphetamines and that you could also produce amphetamine-related psychosis. That’s part of the body of evidence. The other part of the body of evidence is that the antipsychotics, the major antipsychotics, do seem to work like anti-cocaine or anti-amphetamine. And they do quell the more florid symptoms of schizophrenia, especially in its acute manifestations, rather than the sort of burnout schizophrenia that’s characteristic maybe of the much longer term illness. So, given the prevalence of that hypothesis and the support for its validity, did you see any overlap between the metabolic hypothesis and the dopamine hypothesis? Like is the dopaminergic malfunction in your estimation a secondary consequence of a deeper mitochondrial malfunction, or do you think that the dopamine hypothesis is more akin to observation of a symptom pattern rather than the core cause? Because no one knows why the dopamine system dysregulates, right? So, in the final analysis, it’s not an explanation anyways. I think that’s the key. So, first and foremost, I want to say that everything that you just said is true, and that is in fact the basis for the dopamine hypothesis. However, it doesn’t fully account for all of the information that we currently have. We know that serotonergic antidepressants, things like Prozac and Zoloft, can also exacerbate psychosis in people with bipolar disorder or schizophrenia or other disorders. We know that sleep deprivation can exacerbate psychosis in a wide range of people, certainly people with schizophrenia, but even in normal healthy people. If we sleep deprive them long enough, they will begin to hallucinate or have delusions. So, that starts to suggest, wait, serotonin now plays a role, and sleep deprivation, how does that all fit together? Does that all converge at dopamine? It does not. It does not converge at dopamine. However, if we think about, well, what could cause dopaminergic neurons to be overactive and spew out more dopamine than they’re supposed to be spewing out? Then we actually come back to the mitochondrial or metabolic theory that I’m proposing. The metabolic theory can actually explain to us exactly why neurons might be overactive, or the neuroscience term is hyper excitable. But we’ve got decades of science, neuroimaging studies, cell biology studies and others, where we know for sure that people with these brain conditions have hyper excitable neurons. That there are parts of their brain that just start firing when they should not fire, kind of like a pain cell starts firing when it shouldn’t fire. So, in order to understand, well, what would make a cell start to fire for no reason? What would make it hyper excitable or overactive? We actually can turn to the metabolic or mitochondrial theory because that actually connects all of the dots. That can help us understand why would Zoloft or Prozac cause psychosis. That can help us understand why would sleep deprivation cause psychosis. It certainly confirms what you outlined. Why would amphetamines or cocaine cause psychosis? So, I think that, you know, the way that I came to this is I started looking at the entire field, initially just trying to connect the dots for how on earth could a ketogenic diet stop psychotic symptoms in somebody who presumably have a lifelong genetic disorder. That is what most people think of as schizophrenia. It is a lifelong genetic disorder. It’s permanent. It’s fixed. There essentially is no hope for this person. So, I’m trying to understand how on earth could a diet do that. As soon as I put all of that together, though, and started focusing in on mitochondria and metabolism, I started branching out to other diagnoses. And the reason I started branching out to other diagnoses is because we have a problem in the mental health field. Although we have all of these nice diagnostic labels like schizophrenia or bipolar or alcoholism or anorexia or OCD, and we pretend that they are all separate and distinct disorders, the reality is that a lot of the people that we treat in mental health clinics have more than one of those diagnostic labels. It is rare for somebody to have schizophrenia and only schizophrenia. Almost always they have schizophrenia and some substance use problems and some OCD, oh, and depression. Well, wouldn’t you be depressed too if you had schizophrenia? And, oh, and anxiety. Well, wouldn’t you be anxious if you had schizophrenia? We rationalize it away, but it cuts across all of our diagnostic categories that there’s this overlap. And so I started looking into is there any evidence that metabolism or mitochondria could play a role in these other mental disorders? And at the end of the day, what became overwhelmingly clear is that we for decades have been accumulating this evidence and nobody to date has really put it all together. But it is in fact a way to put all of the evidence that we have accumulated for decades. It’s a way to put it together and have it fit and have it make sense. But once you understand that science, it leads to solutions that may actually help people heal and recover from disorders that we are currently telling people are lifelong incurable disorders. Starting a business can be tough, especially knowing how to run your online storefront. Thanks to Shopify, it’s easier than ever. Shopify is the global commerce platform that helps you sell at every stage of your business. From the launch your online shop stage all the way to the, did we just hit a million orders stage? Shopify is there to help you grow. 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Now we know that’s true not least in the fact that for the mental illness to come to the attention of a psychiatrist or a psychologist or an MD for that matter, it’s usually a consequence of the exacerbation of negative emotion and the decrease of positive emotion. So there is a place where there’s immense overlap, right, because it’s just not a problem with the possible exception of mania. It’s just not a problem that comes to people’s attention unless one of the major areas of overlap is a preponderance of negative emotion, the suffering we described. But then you describe that even more densely pointing out that these hypothetically separate diagnostic categories when you aggregate them, they have a tremendous area of even symptomatic overlap. I know for example, can’t remember the study now, but showed that if you do have a person with a so-called personality disorder, imagine you could make a list of all personality disorder symptoms. And the one thing you would get to know from that list checklist was how many symptoms the person in front of you had. That’s a much more useful prognostic indicator than diagnostic category, right. So there’s tremendous overlap of symptomatology. Now you think that points to an underlying commonality of cause, right, and that you’re hot on the trail of this metabolic insufficiency. So let’s start, if you would, walk us through what the mitochondria do. Tell us why deficits in mitochondrial function, like what they would produce, because well one of the things that happens just as you age is your mitochondria start to become less and less effective. So and not everybody who ages shows signs of mental disorder, although depression and pain, etc. associated with aging are far from uncommon. So take us down to the mitochondria. Tell us what they do. Tell us how that would manifest itself in neuropsychiatric disorder. And then maybe we can move to that because the next question is, okay, fair enough, why does the keto diet specifically work? And is that the best of all possible intersessional diets? And then we can think about, well, where should that also fit conceptually in the armament of diagnostic and treatment practices? Okay, so let’s start with what do mitochondria do. So most people who are even familiar with the term mitochondria know them as the powerhouse of the cell. And what that means is that they take food and oxygen and they turn it into ATP. So mitochondria are the things that are actually using oxygen. So we breathe in oxygen and we breathe out carbon dioxide. Mitochondria are using that oxygen and they are producing carbon dioxide that we breathe out. Mitochondria are taking the food. So we have, you know, our digestive tract and other kind of enzymes throughout our bodies that are breaking food down. But ultimately, most of the food, at least 90% of the food that we consume ends up inside mitochondria. So mitochondria are the processors of food. And when they get food, they convert it into one of three things. I could probably come up with more categories, but one of three things. The three things are they convert it into ATP, which is the power unit of the cell. And that’s why they are called the powerhouse of the cell. They’re creating energy or ATP. The second thing that happens to food that we consume is it may not go all the way to ATP. We might just break it down into smaller molecules. And then we use those smaller molecules to produce enzymes or proteins or neurotransmitters or hormones or cell membranes. So our bodies are, in fact, composed of food that we ate. The food that we eat gets broken down and it turns into our cells and our neurotransmitters and everything else. And the third thing that can happen is that mitochondria actually can sometimes divert that energy. And instead of making ATP or making molecules to build cells, they make heat. And in fact, mitochondria are the reason we are warm-blooded animals. Without them, we would not be warm. They can shuttle. They are the things that are making heat. If you get a fever, they are creating that fever. If you’re too cold, it’s because they’re not firing enough. There’s something wrong with their kind of system. That’s what most people know. Research over the last 20 years has completely shattered that simplistic notion of what mitochondria are. And this is the reason. So some people ask, like Chris Palmer, how on earth are you coming up with this? And if it’s really true, why hasn’t somebody else come up with it? Part of it, number one, a lot of other people have kind of sort of come up with what I’m arguing and they are hot on this trail and continue to be hot on this trail. So I am not alone. But one of the reasons most people have not put it together is because this is a cutting edge area of research over the last 20 years. Not really in the mental health field. It’s more in the obesity field, the cardiovascular field, the aging field, the Alzheimer’s disease field. All of these are looking at what do mitochondria do so that they can better understand their kind of diseases. And let me just give you a brief snapshot of what mitochondria do and you’ll begin to understand how it starts to connect the mental health field. Mitochondria make and they help create, regulate and release neurotransmitters, including serotonin, dopamine, norepinephrine, GABA. And in fact, those neurotransmitters then impact mitochondrial function. So it’s a two-way street. The neurotransmitters affect mitochondria. Mitochondria are making and releasing or helping to release those neurotransmitters. Mitochondria help control the expression of genes from the cell nucleus. That’s the whole area of called epigenetics. Mitochondria are central to epigenetic expression in cells. Mitochondria help turn inflammation both on and off. Mitochondria control the first step in the synthesis of some key hormones, including cortisol, estrogen, testosterone. So we’ve long known that HPA axis kind of dysregulation. So too much cortisol or too little cortisol. Then we’ve known that that’s dysregulated in people with mental illness. What would cause that dysregulation? Actually mitochondrial dysregulation is in fact the leading theory for what could cause that dysregulation because they are controlling the first step in the synthesis. They are affected by our diet, our exercise, drugs and alcohol impact their function. But here’s the kicker. Trauma, childhood adversity directly impact mitochondrial function and health. And so it is a way for us to begin to integrate the biopsychosocial risk factors that we know can play a role in what we call mental disorders. In mitochondria, their function or malfunction can begin to help us piece the puzzle together. Okay, so let me summarize that and you tell me if I’ve got my understanding right. So you pointed out that classically speaking, mitochondria regarded as the furnace, the energy source of the cell and therefore the body have been studied in relationship to their ability to produce from the food we eat ATP, which is the fundamental molecule by which we fuel ourselves, let’s say. And then a plethora of chemicals and molecules and also produce heat. Now it sounds to me like what you’ve claimed is that over the last 20 years that chemical and molecular production function of mitochondria has been differentiated and delineated far more comprehensively. So now we understand that mitochondria are crucial for the productions of various hormones and neurotransmitters. They’re part of the factory that does that. They’re also associated, as you said, with the initiation and cessation of inflammatory responses and also the regulation of gene operation. And that’s where we got into a discussion of epigenetics. So for everybody watching and listening and correct me if I’ve got this wrong, Dr. Palmer, it’s like genes are part of the biological code that lays out our physical, psychophysiological function from the ground upward. Genes can be turned on and off and they’re turned on and off according to environmental demand. There’s other reasons they can be turned off and on, but that’s one of them. And so you’re pointing out that mitochondria play a role in the switching on and off of genes like they do in the switching on and off of inflammation and the production of hormones and neurotransmitters. So that’s another reason why delving into the cell down to the level of the mitochondria is a good place to be looking for the common pathway that we’re searching for with regards to the generation or the initiation of mental illness. Okay, so I’ve got that right. Yes. Is that a reasonable? Okay, okay. So then let’s go to okay, good, good. Well, then let’s go to diet. Now I want to lay out another question for you. So as you may know or may not know, and the same would apply to people who are watching and listening, my family has been experimenting a lot with a radical keto diet and that’s an all beef diet with salt. And there’s a variety of reasons why it’s all beef, which I won’t go into, but here’s the fundamental issue from the scientific perspective. And you can tell me what you think about this more broadly and why you’re investigating a keto diet, which is less strict than a carnivore diet. So one of the things we’ve thought and experimented with when we were trying to sort out my daughter’s autoimmune illness was, well, see, we had her tested at one point for allergies to foods, for example, and the basic test came back and skin test and showed she was allergic to everything. Now we thought, well, what’s the probability that she’s going to be allergic to everything? It’s like that just seems unbelievable. But I did know at that point, and this is to your point with regards to diet, one of the most reliable treatments for arthritis, and this works with virtually everyone, is if you fast, your arthritis goes away. Now the problem is it comes back when you eat anything. It’s like, well, wait a second, anything is a lot of things. So then you might say, well, if you were going to investigate a potential dietary link with pathology, you’d want to find the simplest possible, we had her on some like so-called elimination diets, but they made no conceptual sense. And so what we decided on eventually was to search for the simplest possible diet that could actually sustain you over some reasonable period of time. Now a carnivorous diet can do that, as we know from the Inuit, for example, and the Maasai, you can live virtually forever on a carnivorous diet. Now the advantage to that, diagnostically, is that it eradicates a tremendous number of variables. Right? So you could try a carnivorous diet. If it worked, you’d know that diet is a reason. And then knowing that it worked and being in a condition where now you’ve recovered to some degree, you could conceivably add foods back one by one and see if you could regenerate the symptoms. Now I’m curious what you think about that practically and as a diagnostic step in scientific reasoning, but also how you see the relationship between that extremely restricted diet and the keto diets that you described. It’s a really important question. And it gets a little more complicated than sometimes people talk about it. So bear with me. So the ketogenic diet and certainly a carnivorous diet like you just described is probably a ketogenic diet. Unless you’re eating very lean meat, if you’re eating meat with fat, ribeye steaks, other types of meat, if you’re frying it in beef tallow or anything like that, it is a ketogenic diet as well. And I just want to start with the observation that a ketogenic diet is actually trickery in a way. It’s tricking the body into thinking that it is fasting when it isn’t fasting. Oh, I didn’t know that. Oh, that’s very interesting. And so you also get all the do you get the advantages of what is it? I can’t say it properly. Autophagy? Absolutely. Self-devouring. Yes. Okay, so it does mimic fasting. It does mimic fasting. And that’s actually so that was actually the basis for the development of the ketogenic diet originally is that a neurologist a hundred years ago, he knew that fasting could stop seizures. But if you fast people for too long, they starve to death and it’s a really bad treatment. So, so, so he actually tried to figure out is there a way to trick the body into thinking that it’s fasting, get those benefits of fasting, but not have the people starve to death. And like you said, is there a way to actually provide adequate nutrition? And when we’re thinking about these interventions in children with epilepsy, for instance, we not only need to think about adequate nutrition, we need to think about nutrition that can help those children grow and thrive and gain weight and develop their bodies like they should. And so it was this ingenious neurologist who developed the ketogenic diet for that purpose. And so first and foremost, I want to say that there are kind of two big issues. One is that some people are allergic to things that they are eating, or maybe they are having a toxic reaction to things that they are eating. And we can get into processed foods and all of the artificial stuff. And that is absolutely happening in some cases. And therefore, the treatment plan with that model in mind is figure out what the problematic foods are, eliminate them from the diet, and then you’re good to go. But actually fasting and fasting-mimicking diets, like the ketogenic diet, like your daughter’s kind of heart lion diet that she’s the lion diet that she does, that that is actually mimicking the fasting state. And what that’s really doing is, it’s actually changing metabolism in the entire body. It is dramatically reducing inflammation. It is highly upregulating autophagy. And from my hypothesis, really important, something called mitophagy, which is mitochondrial repair. So it’s basically getting rid of old and defective cells, but also old and defective cell parts, including defective mitochondria. That when you’re in this fasting state or fasting-mimicking diet state, your body is doing all of this repair. It’s getting rid of old parts. And then when you eat, replacing them with new ones. And that can actually have profound healing potential, independent of whatever you were eating. Whether you were eating a healthy diet or an unhealthy diet or anything in between. Okay, okay. Those benefits can be helpful to people. And the fascinating thing, people have known this for millennia. Every culture on earth, pretty much, just about, has used fasting as a healing intervention or a religious intervention, which was often paired with healing, for millennia. Hippocrates knew about this. Jesus knew about this. In one of the versions of the New Testament, the New Testament, his disciples called him to say, This child is seizing and we are praying and it’s not stopping this child. They thought it was demon possession, actually. So they described frothing at the mouth and demon possession. They said, Jesus, we’re praying, we’re praying and it’s not working. And he said, This child needs fasting plus prayer. And the fasting plus prayer stopped the seizure, stopped the demon possession. So this has been known for millennia that fasting can help. And people back then weren’t eating processed foods. So it’s not a processed food problem. It is a physiological way to induce healing. And you basically are tapping into the body’s innate ability to heal and repair itself. That’s what you’re doing when you fast. The 40 days leading up to Easter, Lent, starts on Ash Wednesday. That’s February 14th. This is a time of intense prayer, fasting and giving. 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Hallow.com slash Jordan for an exclusive three month free trial of all 10,000 plus prayers and meditations. So we need periods of eating and not eating. And the not eating periods are the repair periods. And so in a culture like ours, where you can eat any damn thing you want all the time, and everyone does, what that implies is that not only are we making ourselves obese and increasing our proclivity to diabetes at a rate that’s absolutely staggering, but we’re also perhaps never allowing ourselves to enter into the biological condition that’s associated, as you said, with the repair processes that go all the way down into the cellular. And now, with regard to the relationship between fasting and the ketogenic diet, is the ketogenic diet a sufficient replacement for fasting or a carnivorous diet? Like, do you know, maybe we don’t know this yet, are there benefits to ceasing food intake altogether that can’t be accrued from merely eating, let’s say, a carnivorous or a keto diet? There are. And even the epilepsy researchers have found this, and they were initially a little surprised that that was the case. But fasting is, in fact, different than maybe the carnivore diet, which is different than a ketogenic diet, which is going to be different than maybe a whole food plant-based diet or the paleo diet or the CrossFit diet or whatever diet you want to talk about. And the reality is that that range of dietary interventions can play a role for different people. And people don’t need the same dietary intervention for their whole life, necessarily. So sometimes you can do a fast, get some healing or repair or just a reboot, if you will, and that may be enough. And there are plenty of health and fitness gurus who say that they do a two or three day fast once or twice a year for that reason, that they are trying to stimulate autophagy, they’re trying to reduce their risk for cancer based on this science. We don’t have long-term studies to know for sure if that really works, but the science suggests that it might. But I think other people, in fact, are really sensitive to different types of foods. Your daughter is a perfect example of somebody who might be sensitive, and she may do best with an all-meat diet and a very simple diet. And are there other things that she might be able to eat and remain healthy? There might be, but she would have to go on that kind of exploratory pathway and one at a time introduce a new food and see, can I tolerate this food? Can my digestive tract tolerate this food? Do my autoimmune symptoms start coming back when I eat this food or not? And so I think first and foremost, I do want to just point this out, that I think that there’s a range of options for different people. I’m not here to say there’s any one diet for all human beings, because I don’t believe that there is one and only one dietary pattern that’s optimal for all humans. I think different people need different diets or can benefit from different dietary patterns at different times in their lives, and depending on what health conditions they have. And I think on one hand, that’s really hopeful and useful. On another hand, some people get really frustrated with me because they say, Dr. Palmer, just tell me what to do exactly. And I don’t know them at all, and they’re just on social media or whatever, and they tell me exactly what to do. I’m like, I don’t know you. I don’t know your health conditions. I don’t know what your digestive tract is like. I don’t know what your food preferences are. How should I know what you should eat? It doesn’t mean it’s not a solvable problem. It is a solvable problem. It’s not rocket science. It really isn’t rocket science. Your daughter has put out amazing information for people, very practical step-by-step instructions for people who want to try her dietary pattern to see if it might help them. There are other, plenty of other people who also put out similar kind of instruction manuals, if you will, how to follow a whole food plant-based diet, how to follow this diet, how to follow that diet. So what I would encourage people to do is kind of experiment. Figure out, well, what works for you? Where are you at in terms of your health? What sits well with you? What are your overall fitness goals? If it’s a man who’s trying to build a lot of muscle and he’s working out a lot, he needs more protein if he really actually wants to achieve building muscle. You can’t build muscle from non-protein kind of plant-sourced foods. You just can’t. So it’s a range of options, but we have enough science. We have more than enough science for me to be able to say, it is very clear and understandable why your daughter experienced such tremendous health benefits by doing the diet that she did. It is not quackery, which I know people, I actually know your daughter. I mean, because it’s so preposterous. It took us a long time to swallow the fact that, first of all, she couldn’t eat anything. My wife and I basically have the same diet. It’s a very radical solution and everyone should be skeptical of radical solutions. So let me agree with you for a second and then point out a potential area of confusion or disagreement, if you don’t mind. Well, you pointed out very clearly that the advantages of a reductive diet are twofold. One is you may well be not able to tolerate a given food. So your body’s actually treating it like a toxin and that’s going to be a more or less serious problem for all sorts of people in different ways in relationship to all sorts of different foods. Okay. So a restricted diet can enable you to start to evaluate where you might be reactive. And then there’s a separate set of benefits that go along with the keto diet slash fasting. And that’s the encouragement of autophagy. Say that again. How do you say that? So autophagy, mitophagy. Autophagy. It’s gene and mitophagy. Yes. Okay. So you want to initiate that. Now the point I’m less, I’m more confused about is you said there’s multiple pathways and that there is a point in experimentation. And I agree wholeheartedly with that, but the practicalities tend to get in the way, you know? And so the reason that we concluded that it was worthwhile, let’s say, to publicize the carnivorous diet is because it’s actually, it’s the fastest and simplest way to reduce the variable problem to unity. It’s like, okay, if you just eat beef, that’s all you’re eating. It’s one thing and you can do that for a long time. That seems to me to give you the optimal chance to experiment. Because when we played with like the, I don’t remember what the other diets were called. There’s one FADMAP, is that right? FADMAP diet. FODMAP, yeah. FODMAP, FODMAP diet. Right. Well, it made no sense logically. And there were still things within it that looked very contradictory. So I understand your impetus, your insistence on the utility of experimentation and your proclivity to presume that there’s no one size fits all solution. But we have said that, having said all that, a keto diet and a carnivorous diet does produce autophagy and mitophagy. And that’s a very necessary thing. And it also is a very simple approach, even though, you know, it’s behaviorally complex and that’s a problem, because it’s actually hard to only eat meat. So what do you think, like, what do you think are you willing to speculate on what might constitute a reasonable, generic approach to dietary experimentation? Because it is a complex thing to undertake. So I completely agree with your approach and your kind of, I agree that a carnivorous diet may in fact be the gold standard elimination diet to see if a change in dietary pattern can produce the health benefits that a person is seeking. The reason I’m hesitant to recommend it for everybody is because I already know the nutrition experts will vilify me along with you and Michaela and others. And so I want to throw them a bone. Are those the same experts that recommended the food pyramid? Don’t get me started. Don’t even get me started on that, because that food pyramid really messed up my own personal health. But so for the people who say, well, no, there’s no way I’m only going to eat meat, then I want to at least meet them where they’re at and say, fine, you don’t have to only eat meat. There are lots of options. You could try the FODMAP diet. You could try other diets. You could try a whole food plant-based. Like, I don’t want to give up on them and I don’t want to let them know that it’s like carnivore or nothing. So I want people to understand. However, if somebody is really, really sick and needs a drastic intervention, doing a water-only fast, maybe with some electrolyte supplementation and other things, doing a maybe a medically supervised even, because if this person is really sick, they’re already down and out. And so maybe we need to monitor them. But doing a water-only fast is really the ultimate elimination diet, because we’re eliminating all food. We’re really letting the digestive tract rest and repair. If the digestive tract is inflamed, we’re allowing maybe that inflammation to subside. We know that there is a gut-brain connection and that that plays a role in a wide range of mental disorders, all the way from autism to depression to anxiety to schizophrenia to binge eating disorder to bulimia, nervosa. There’s a wide range of mental disorders. We have a growing body of evidence that the gut actually, problems in the gut get transmitted through the vagus nerve and through other endocrine pathways, through serotonin actually and other pathways up to the brain, and that that directly impacts brain function and our brain metabolism, brain metabolic function, which then impacts neurotransmitters and everything else. So water-only fast would be maybe the most drastic intervention. But again, you can’t fast for too long because you’re going to starve to death. And I wouldn’t want to do that in an underweight person. And the second best version is exactly what you’ve described. The lion’s diet, which is meat, just meat, beef alone, it’s enough nutrition to sustain a human. There will be people already, I can hear people already saying, fiber, fiber is really good, Dr. Palmer. How dare you get rid of fiber or this is a, I’m not saying you don’t need it if you don’t produce much waste and you don’t produce much waste on a carnivore diet. So the thing is, I think you’re right though, that if somebody’s really in trouble with serious symptoms or if somebody just wants to do maybe a one month or three month experiment to see, will this improve my symptoms? I would actually encourage people to give it three months. Right, that’s about what we’ve concluded too, it’s about three months. Do a carnivore diet or a ketogenic diet if you don’t want to do that. Because I have some patients who, you know, I’ve talked about the carnivore diet with them, they’re like, no way, no way. I’m like, okay, well, let’s do a therapeutic ketogenic diet. The therapeutic ketogenic diet, I can solidly stand behind. And the reason I can solidly stand behind that, you know, the carnivore diet is a ketogenic diet, but there are other variations of ketogenic diets. And the reason that I can solidly stand behind the ketogenic diet is because we have an enormous evidence base all the way from animal models, cell biology models, to human clinical trials of ketogenic diets for seizures, for weight loss, for type 2 diabetes, for type 1 diabetes, for kidney disease, for cancer, and other conditions. And we have good evidence that a ketogenic diet can in fact be safe, can be highly effective for many of those conditions. And so I just stand solidly behind that science or on the shoulders, so to speak, of that science. But I don’t disagree with you in terms of what you’re saying about the carnivore diet and some of the benefits. Well, also I should say too, like as a behavioral psychologist, I mean, there’s no sense suggesting something to someone they won’t do. And so if you can generate a plethora of alternatives, some of which aren’t quite so extreme, and they might work, more power to you. So, okay, so let me ask you a specific question. I have a specific reason for this. So I’ll start with a bit of a prodroma. So my wife had a very rare form of cancer, a Bellini tumor in her kidney. And the 11-month mortality rate for Bellini tumors, which have only been reported about 200 times, is 100%. And she lived through it. Now, she had surgical interventions, and it’s a complex story. But we believe tentatively that the reason that this didn’t kill her, apart from the surgeries and various other factors that came into play, was perhaps because she was on the carnivore diet, and very religiously, so to speak. Now, I have a more personal reason as well, more specifically personal at the moment for asking you this question. I know of someone who’s in very deep trouble, who’s suffering from cancer. And I’m wondering, you know, if you have a loved one who’s afflicted in that way, and they’re starting to run out of options, by the way, on the treatment front, and facing the proliferation of their cancer, I know you can starve cancers. So as a practicing physician, at what point in the progression of cancer do you think it’s reasonable or unreasonable to say, look, you got nothing to lose from a water fast for three days, followed by like a month or two months of pure carnivore diet, and then we could reevaluate your circumstances at that time? And so what, because I’m thinking about having a chat with this person about exactly this. And so I’m wondering, like, what do you have to say? I’m not a physician, right? And so I’m wandering out of my territory to some degree on the dietary front, although that became necessary for all sorts of reasons. But I’m also extremely interested in the neuropsychiatric implications. So what do you think on the cancer front? So I’m not an oncologist. So I want to say for the record, this is way out of my territory. And I’ve actually been asked this question by some close friends, even. Should I do a ketogenic diet? I have cancer, I’m fighting cancer, I’m going to do the chemo or radiation or surgery or whatever, but should I also do a ketogenic diet? And my honest advice is because I am out of my area of expertise, I really encourage people to work with their oncologist. Fair enough. And the reality is that we have an increasing number of clinical trials that are ongoing right now where they are adding ketogenic and other dietary interventions to the chemotherapy or radiation or to see if in fact it may play a role. And we know that, you know, in general, my sense from the published literature, Dr. Thomas Seyfried is kind of an expert in this area of ketogenic diets for cancer. What’s his name? Thomas Seyfried, S-E-Y-F-R-I-E-D, I think. Thomas Seyfried. Thomas Seyfried. So he’s written a book on cancer as a metabolic illness. In general, once cancer gets started, at that point, it’s probably too late for a dietary intervention in most cases to cure the cancer. However, we have strong reason to believe, and this is why these clinical trials are getting started, we have strong reason to believe that a dietary intervention like a ketogenic diet or a carnivore diet or water fasting or intermittent fasting may slow the growth of that tumor, may, and slowing the growth of a tumor gives us more time to do the definitive intervention to get that cancer out of that person’s body. Well, also, there’s good evidence that fasting reduces chemo and radiation-induced nausea. So that also makes the treatment more tolerable, at least in principle. Absolutely. And these dietary interventions are decreasing inflammation, they are decreasing they are decreasing insulin, and insulin is a growth factor, and it is a growth factor for tumors as well. So again, we’re basically doing everything we can to try to slow the growth of this tumor while the oncologists are trying to kill the cancer with surgery, chemo, or radiation. It sounds, thank you for sharing your wife’s story. Well, it’s an anecdote, but anecdotes are good. Well, look, man, they’re not data, but they’re good sources for hypothesis generation. I think they are great sources. They are fantastic sources for hypothesis generation. And again, you, anybody who says, well, that’s just an anecdote, I would want you to push back and say, no, actually, there are clinical trials underway. And that is not anecdote anymore. She is an example of a scientific theory that is progressing through the oncology field already. So anybody who tries to say, well, you know, that’s just an anecdote. Well, no, it’s not just an anecdote. There’s a tremendous body of science. There are clinical trials underway now. There are animal models supporting that ketogenic and other dietary interventions can slow the progression, can actually shrink tumors. The reason I’m hesitant to say cure is because, so Dr. Seifried, the reason I brought him up is, you know, he has published a couple of case reports in the medical literature, and there was one woman who had what was billed as an incurable brain tumor, a glioblastoma. And she went on a very, very strict, medically supervised ketogenic diet, calorie restricted even. And in fact, her glioblastoma shrunk to the point that it was undetectable. But after about nine months, so they thought maybe she was cured because it shrunk a lot. She stopped the diet. The tumor came back with a vengeance, and she died. So I just point that out that I think that we still have to encourage people to work with oncologists and try their best to kill all cancer. So maybe we could close this off. Well, first of all, we can close it off if you have anything else that you need to bring to people’s attention. But one of the other things I’d like to hear from you, you know, you told that story of your patient with schizoaffective disorder and his remarkable recovery with regards to his accompanying obesity, as well as his mental illness. What else have you seen that was part of what motivated you to pursue this so assiduously? Tell us some more stories. Well, so I can tell you lots of stories, but I don’t want anybody to come away from this thinking this is anecdotal anymore. For me as a professional, it started with that anecdote. It is no longer in the realm of anecdote anymore. We have hundreds, if not thousands of patients with bipolar disorder, with schizophrenia, with chronic unrelenting depression, with OCD, with anorexia nervosa, with alcoholism, for God sakes of all things. We have people with all of these different diagnoses who are coming out of the woodwork sharing their stories of recovery and sometimes remission. Some of these people are able to get off all of their psychiatric meds and remain in remission. We have clinical trials underway, at least I think 15 clinical trials underway now, at Harvard Medical School, at Oxford, at Johns Hopkins, at UCLA, at UC San Francisco, and many other institutions, literally around the world. We’ve got clinical trials underway. So anybody who wants to say, well, this is just anecdotal evidence. No, it’s way beyond anecdotal evidence now at this point. But the stories that I want to share that I just alluded to, a woman who had bipolar disorder had become psychotic when she got manic. So awful, awful illness. She is sharing her story publicly about how the antipsychotic medications and mood stabilizers that she took made her clinically obese, made her gain massive amounts of weight. She felt awful. She had low-grade depression. She was plagued with recurrent suicidality after starting some of the medications that she had to start. And she has now put her bipolar disorder into remission for over two years. She heard about me. She heard me on a podcast. She has read my book. She implemented the treatments that I’ve outlined. And she is off all her medicines in full remission. I have literally, I have thousands of people reaching out to me for help. So I should say for the record, unfortunately for your listeners, I’m not taking new patients or consultations. I’m really sorry because I’ve literally got a wait list of over 2600 people already. But I have treated patients, one person in particular, I can share their story publicly because they are very public already. So I am not breaking any confidence. They are billionaires, literally billionaires. Their son had bipolar disorder, a really bad case of it. He had tried 29 different medications in and out of hospitals, in and out of residential treatment programs, seeing the best bipolar specialists in the world. And they as a family, he as an individual, she as a mother, were told in no uncertain terms, your son has treatment resistant bipolar disorder. He is going to be disabled for life. You need to accept that he is going to be sick for the rest of his life. You are in denial. Your denial is the problem. Stop denying that your son has a serious mental illness and he’s never going to get better. Just accept it and move on. They came to me about three years ago now saying, we heard about you and this diet and bipolar and we were not giving up yet. We’re not ready to give up even though everybody’s trying to encourage us to give up. Will you help us? I talked with them. I met with his treating psychiatrist and we partnered together because I’m in Massachusetts, they’re in California. So I wasn’t legally allowed to treat him as the treating psychiatrist. So I was a consultant. It is now three years within four months of starting a ketogenic diet. His bipolar symptoms were in full and complete remission. He is off of probably 75% of the medicines that he had been taking. So he’s not completely off medicine at this point, but he is slowly but surely tapering off. But he has not had an episode since. He does not have bipolar symptoms. His illness is in remission. He has finished college. He works full time. He has a full life. He’s excited to be alive. And this was a man that was being told by the best experts. They are billionaires. They had access to the best of the best. And the best of the best in the mental health field were encouraging them to give up hope. They were encouraging them to just give up, just write him off, just accept that he’s going to be disabled for life. And they refused to accept that. And he’s living a new life now. And so they have created a non-profit organization called Metabolic Mind. They have funded, they don’t share their financials with me, but to the best of my knowledge, at least probably 70 million dollars of research now focused on bipolar disorder and metabolic strategies. They are really helping to move this field forward. And we’ve got an international team of psychiatrists, neuroscientists, mitochondrial biology experts, metabolism experts, all working together to move this field forward. I just got a major gift, a three million dollar gift from a different philanthropist to start a new program at McLean Hospital, the Metabolic and Mental Health Program. And we are going to be launching this. So for people who listen to this are skeptical, I get it. You have every reason to be skeptical. This is new and shocking information. And I am trying to encourage people to not give up hope. I am trying to encourage people that even if you’re told that there is no hope, that you just need to accept that you’ve got a chronic, horrible, debilitating illness, and that’s just the way it is, I want you to rise up. I want you to learn more about this work. I want you to learn more about what you can do. And I want to empower people first and foremost with hope, and then with knowledge, and then with practical strategies that they can implement. Just like you and your daughter and your wife and others have implemented, you take control. You learn things, you take control. And sometimes it really works out beautifully and people get amazing health outcomes. And that’s the way it should be. Hey, Dr. Palmer, that’s a very good place to stop. And so we’re going to stop with that. Thank you very much for taking my questions and walking everyone through that. Congratulations on the new gift. And I’m very much looking forward to seeing what happens with your center. Please don’t hesitate to stay in touch and let me know whenever you come across something that you think is new and particularly compelling. I mean, this is a ridiculous… I mean, I’ve seen literally hundreds of people on my tour now who’ve come up to me in the meet and greets afterwards and have said, you know, I’ve lost 150 pounds in the last 10 months. People told me that was impossible. I’ve got my life back. My psychiatric disorders are in remission. I’m wondering, maybe this is a closing thought. Tell me what you think about this, because I think we’re at this point. And I think this is perhaps what you’re pointing out. My sense is that with the really severe mental disorders, so intractable depression, especially in the absence of life circumstances that would point in that direction, manic depressive disorder, the serious psychosis, that as mental health professionals, as physicians, our primary assumption at the moment should be that these are metabolic related or other physiological disorders until there is compelling proof otherwise. 100%. I am firmly committed to that. And again, there are decades, there’s decades of science to confirm this. The neuroimaging studies, all of the genetic studies, when they look at the genes that increase risk for schizophrenia or bipolar disorder, and when they look at what do these genes do, guess where they converge? Metabolism and mitochondria. It’s not dopamine. It’s not serotonin. It’s metabolism and mitochondria. And in many ways, this is a game changer. And the reason it’s so important is because there are solutions available today, like dietary strategies, that people can implement. We don’t have to wait 50 years for some novel treatment to work its way through the development and kind of, you know, review process with the FDA. We don’t need to wait. We’ve got things we can do today. All right, sir. Well, I’m going to continue my discussion with Dr. Palmer on the DailyWire Plus side of the interview dividing line, let’s say. And so I want to find out from him a bit more about what shaped his interest in the medical community, in medical practice. I want to find out why he focused on mental health. I want to see what his vision is for his new centre into the future and so on. If you’re inclined to join us for that additional half an hour, please feel invited and welcome to do so. Thank you very much to the film crews here. And are you in Massachusetts? Are you in Boston today? I am in Arlington, Mass. And I understand. Oh, you’re in Arlington, my old hometown. Yes, your old hometown. My own town. Yeah, yeah. So that’s great. All right. All right. And so thank you to the film crew here up in Northern Ontario as well. And thank you to everyone who’s watching and listening. Your time and attention is much appreciated. Thank you very much, sir. Thank you.