Metformin, Insulin Resistance and Bipolar depression: From research to clinical care
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- Опубликовано: 18 май 2024
- Dr. Cynthia Calkin's study using Metformin in treatment-resistant Bipolar Disorder showed that improving insulin resistance dramatically improved depression outcomes. This research is helping shift the paradigm for how we treat bipolar disorder. Her clinical practice and research studies demonstrate that metabolic dysfunction significantly contributes to mental illness and, perhaps even more importantly, that treating metabolic dysfunction results in significant symptomatic improvements.
This is a dramatic clinical shift in psychiatry, and as you will hear, it has been slow to catch on within the psychiatry community. But with Dr. Calikn’s research and her desire to help as many people as possible, Dr. Calkin is helping spread the word so more clinicians understand the benefit of approaching patients from a metabolic perspective.
Studies referenced in this video:
Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study): A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial pubmed.ncbi.nlm.nih.gov/35120...
Insulin Resistance and Blood-Brain Barrier Dysfunction Underlie Neuroprogression in Bipolar Disorder pubmed.ncbi.nlm.nih.gov/34113...
Table of Contents:
0:00 - Introduction
1:57 - Interview with Dr. Cynthia Calkin
46:06 - Conclusion
Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.
Learn more about metabolic psychiatry and find helpful resources at metabolicmind.org/
About us:
Metabolic Mind™ is a nonprofit initiative incubated by Baszucki Group. Our mission is to provide education and resources in the emerging field of metabolic psychiatry, including ketogenic interventions for mental disorders.
Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.
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This is revolutionary - congrats to Dr Calvin for blazing the trail. 🧠🙏🏻💜
Thank you both for a detailed and informative discussion of the role of Metformin in addressing treatment-resistant conditions. What particularly interested me was the transition from general medicine to psychiatry, and the recognition that there is no clear separation of mental and physical health. "Mens sana in corpore sano".
The research that is coming out on metabolic health is fascinating, and there are so many different aspects and perspectives - whether related to metabolic disorders, such as Type 2 diabetes, metabolic syndrome, insulin resistance, autistic spectrum disorders, dementia, Alzheimer's, Parkinson's, cardiovascular health, nonalcoholic fatty liver, glycation, leaky gut, leaky blood brain barrier - the list is huge and growing.
So too is the number of people with these health issues, and the cost of treatment, days lost to illness, impact on families and society.
A lack of qualified professionals does nothing to improve the situation. Nor does the resistance to change of people who are in a position to make significant change, for the benefit of patients, their friends and families, and society.
The silo-approach to medicine, where each speciality keeps to its own protocols, refuses to take on board the lessons learned from other disciplines and, in some ways is prevented from adopting them, because of doctrine, dogma or protocol, does not serve anyone.
As a lay person who has experienced mental health issues, it pains me to se that the solution, for so many people - myself included - can be so mind-blowingly simple, and that screening for metabolic disorders is not a standard part of medical and psychiatric assessment.
I struggled for years with my weight, health and mental health, and the advice I received was sadly lacking in evidence or effect.
Since cutting out carbohydrates, at the end of last year, I have reversed the pitting oedema, night blindness, brain fog, depression, anxiety and, in all probability, type 2 diabetes.
I applaud your efforts to bring the research to the attention of the public, medical professionals and those in authority.
The benefits of addressing metabolic disorders with metabolic solutions, at minimal cost, can do much to address the seemingly insurmountable challenges of the current health crisis, financial cost, overstretched healthcare system and societal ruin.
Most ppl on standard diets do have impaired metabolisms... not to mention that psych meds... especially lithium destroy thyroid function & that in turn contributes to metabolic disorder as the thyroid is truly master gland which impacts heart rhythm, muscular contractions, cholesterol levels, sleep and brain functions..... please continue your work.... thx for what you do....
Thank you to Dr Calkin for her thorough clinical studies and papers. They have changed my clinical practice ❤
Thank you SO much for helping setting this Channel up and getting onboard. I remember years and years ago doing very low-carb for about 6 months and being able to throw my anti-depressants away. Unfortunately I didn’t know that satiety is key to staying on task with diet/metabolism, so I’m now onboard for a new journey. Have watched a ton of Diet Doctor stuff. Throwing away a number of Psych medications would be my dearest wish!
Best of luck and keep us posted. Bret has a new video about tapering meds coming out soon with some tips and tricks from Dr. Ede and my very own son. Their advice is to go slowly!
I’m so excited for Matt as he continues to taper lithium. Once I had been on my vegan ketogenic diet for 5 months, I was able to reduce my lithium from 900 mg a day to 600 mg a day, and remain within the therapeutic level. Not sure if I want to go down from there, but my psychiatrist is retiring soon and once I become Dr. Sethi’s patient (she put me on her waitlist )I will work with her.
Check out Dr Chris Palmer.
@@mathewmapram7108 Yes indeed, we endorsed the back of the book.
Fantastic talk. I agree as someone who has has long term Metabolic and mood disorders. Definitely a structured program, but constantly reviewed with participant feedback and ever-evolving. 🙏🏻❤️
Very interesting work 🙏🏼 proving further at the root this a metabolic issue
I’m cheered by the fact you are all the movers and shakers to help us simple folk.
Excellent information. Thank you. I will share with my neighbor who is a 3rd medical student going into geriatric psychiatry. He is currently reading Dr. Palmer's book
It was really validating hearing her say you can encounter completely different people depending on what phase a person with bipolar is in. It’s fascinating (and so counter to the dominant way of thinking) how personality can be so variable within a person. Is personality a metabolic phenomenon?
My son would say that when he experienced bipolar episodes, his personality was hijacked by his illness. As soon as he got better (on keto), his personality returned. He is now once again the intense but measured, curious, driven, intelligent person he was before his disorder took hold. Massive self-discipline, self-control and insight. All that was submerged by bipolar, but it was still there! That is the message of hope our story can offer.
@@jan_ellison_baszucki it does give hope and a sort of therapeutic relief to loved ones who’ve been impacted. I’ve had an uncanny amount of people in my life (starting with my mom) with bipolar, schizophrenia or other personality instability and experiencing the personality change is traumatic. Learning the science behind it helps me understand it wasn’t my fault.
@@FindingFI Most definitely not your fault! Or theirs.
An insightful and unique discussion,a big food for thought..❤🎉
Ive been watching Dr Eric Berg video recently and he was saying that Metformin is one of the drugs that depletes vitamin B1 and also B12 in the body. Which can result in a huge variety of neurological symptoms. So Metformin not so good in the long term, perhaps or suplimenting with B vitamin patches. Ketogenic diet although a bit more hassle initially sounds much better in the long run
The standard American diet depletes all vital vitamins and nutrients.
Can you do some research on the MTHFR gene mutation please?
Monosaccharides such as glucose and certain drugs stimulate/up-regulate TRPV1 and this leads to the issues discussed in my previous posts.
Yes certain drugs increase TRPV1 that increases insulin and in turn insulin increases TRPV1 on cells that then forces glucose into cells independent of the insulin receptor and TRPV1 on mitochondria causes reactive oxygen species production, in excess of the cell’s antioxidant reserves. Mitochondrial damage and insulin resistance results. Hyperinsulinemia inhibits autophagy necessary to recycle damaged mitochondria.
Oxcarbazepine used in some cases increases TRPV1 and TRPV4.
What about studies with other meds for bipolar disorder...not just lithium. That's what I'd like to see.
My son is diagnosed with schizophrenia and has been on clozapine a long time. He has a very enlarged stomach and ha recently been prescribed metformin. It will be interesting to see if it helps
When i have mental disorders my docter give me risperidone medicne after taking this i have insulin resistance big belly fat low mood anxity anger..i dont find any solution till now from last 1 year
Is blood/brain barrier leakage really leaky gut?
No wonder SSRI’s aren’t working!
How are you testing for insulin resistance
You can watch this video for some suggestions ruclips.net/video/W-lmYCqjtmg/видео.html
Maybe you should look into why people become insulin resistant in the first place and how to reverse it.
It’s clearly the foods we eat. Specifically the refined sugar, processed carbs and heavy pumped foods full of preservatives, chemicals, heavy metals + a sedentary lifestyle with high stress
I want to make sure I understand. If a patient stops responding to lithium and you fix their diet they then are able to respond to lithium again?
Dr. Calkin's study looked at improving insulin resistance with metformin and didn't specify anything about lithium. So I'm not sure the conclusion is accurate the way you described it.
@@metabolicmind Thank you for your reply. I am specifically referring to your discussion just after the thirteen-minute mark of the video. Thank you.
Long term lithium use can lead to kidney disease. I had stage one kidney disease but after being taken off lithium, my kidney function healed, thank God.
How can I get the paper ?
There's a link to it in the video description
So these people are insulin resistant in the Brain only? And metformin helped with that? Im not sure i understand 🤨
Virta Health not Polypharmacy
Doesn't metformin affect metabolic health (side affects ) ?....this lady recommends it for bi-polar ?! , after playing down the keto diet (no side affects ) for bi-polar ?!..wtf . Is she biased towards pharmaceutical treatments , or what !. The interviewer should have asked if she is receiving "sponsorship" !!.
She is not receiving sponsorship. She had not been familiar with nutritional ketosis when we started up our metabolic psychiatry community. We need to be offering a range of options as not everyone will be up for a dietary intervention. It may be that stabilizing people on metformin could allow for introduction of nutritional ketosis down the line. So we are all in supporting Dr. Calkin's work. It also demonstrates mechanistically that we are on the right track with metabolic interventions like keto. All are welcome here!
@@jan_ellison_baszucki good breakdown 🙏🏼
It’s also matter of money pasta is cheap so they feed it to people with mental problems in this homes and make things worse all for the sake of money
Sooooo, she wants to ADD extra meds to our already heavy prescriptions, then if metformin "kinda works", she will add on another med.
If she is ONLY truly using this as 1st line defense, to then transition into nutritional therapy AFTER insulin is corrected thats "doable".
BUT... BUT... I'm not getting that "feeling" from her. ("Always gonna need a mood stabilizer")
WE NEED HOPE... its like she's saying our population is incapable of a med free life.
Overall... this still benefits the "big pharma" group. & keeps us reliant on meds. 😢😢
These drugs work by stabilising GABA, which can be done from lifestyle change. If an issue comes up and GABA is effected perhaps CBD is the most appropriate medication to use without overall metabolic disfunction. Lots of the meds cause weight gain, which is metabolic disfunction. When a person is stable, they should be lowering meds with the plan to discontinue use. I had bad cholesterol, large waist, and blood pressure getting close to not being fine. Only thing that was OK was insulin. Now all my markers are perfect for metabolic function, certainly didn't use meds. My GABA has to be good. I wanted a HGH test to see if my GABA was fine, but they didnt do it on my blood test. My doc never says symptoms are less we will decrease valproate. He is like you have to take X amount to be in the therapeutic range, it doesn't matter if I am completely psychotic or going good. I have to regulate my own dosage. Which is fine, now that I am 52 and have been bipolar my whole life.
I agree. I was bummed what she said this. The good thing is that there are many doctors who can and will get their patients off all meds
I view her approach as helping move the needle. Don't throw the baby out with the bath water. This is a super helpful study and if they can get it replicated all the better. Looking up the details of metformin it looks like a pretty beneficial and low impact medication.
She has an obvious bias towards pharma treatments. She minimised keto diet affects and side affects of metformin .I pity the patients trusting her , in good faith , and ending up more obese or worsened symptoms of diabetes .She then hides behind the "its genetic" cover when she admits her patients don't get better .
@@mikefarinha long term use of metformin is recorded as having negative affects on metabolic health .She flippantly talks about this like she is chatting about skittles .I find her quiet offensive .Rob lustig talks about it on one of his utube lectures.
Depression is type 4 diabetes!
Very interesting.