9.1 Low-Dose Lithium: RANT + Guest Intro

[00:00:00] Welcome to Renegade Psych, a nuance podcast dedicated to informing the American public about

[00:00:05] the flagrant shortcomings of our healthcare system.

[00:00:08] I'm a board certified psychiatrist and along with my guests break down interesting and

[00:00:12] important topics into several segments to appeal to both the general public as well

[00:00:16] as medical and psychiatric students, residents, and practitioners.

[00:00:20] My primary motivations are to appreciate nuance in major medical and psychiatric discussions,

[00:00:25] educate listeners on the undue and widespread influence of big business and healthcare,

[00:00:30] and provide accurate and reliable information on relevant mental and medical health topics.

[00:00:36] While I'm still young and have a lot to learn in my career, I cannot continue to stand

[00:00:40] idly by while so many in my field repeatedly fall victim to pharmaceutical interests, misinformation

[00:00:46] and manipulation of existing data at the expense of American's health.

[00:00:50] Whether you struggle with your mental health, work in behavioral health or the healthcare

[00:00:54] system, or want to better understand our healthcare systems over promise and underdeliver

[00:00:59] status quo, my guests and I hope to provide public education on some of the most pertinent,

[00:01:04] underreported and controversial issues in psychiatry, mental health, and healthcare in general.

[00:01:08] Disclaimer, this podcast is for informational purposes only.

[00:01:11] The information provided in this podcast and related materials are meant only to educate.

[00:01:14] This information is not intended as a substitute for professional medical advice.

[00:01:17] While I am a medical doctor, many of my guests have extensive medical training and experience.

[00:01:20] Nothing stated in this podcast nor materials related to this podcast, including recommended

[00:01:23] websites, texts, graphics, images or any other materials should be treated as a substitute

[00:01:27] for professional medical, psychological advice, diagnosis or treatment.

[00:01:30] All listeners should consult with a medical professional licensed mental health provider

[00:01:33] or other healthcare provider if seeking medical advice, diagnosis or treatment.

[00:01:36] Or put more simply.

[00:01:37] We need help like this guy.

[00:01:39] Call your own doctor.

[00:01:43] Somebody get this guy some help.

[00:01:52] In this series, we are talking more about the best drug in psychiatry, lithium.

[00:01:58] With a focus on low doses or microdoses, or what some call nutritional doses of lithium.

[00:02:04] While the academic community has known lithium's gold standard role in bipolar disorder, formerly

[00:02:10] known as manic depressive illness spectrum, for many decades there is also an abundance

[00:02:16] of historical evidence in its effects on reducing the risk of suicide and preventing recurrences

[00:02:23] of depression in what we now call major depressive disorder, which also used to be on that manic

[00:02:28] depressive illness spectrum.

[00:02:31] It's crazy to me that I was taught to rely on a class of medications, the serotonin

[00:02:36] reuptake inhibitors, that actually increase my patient's chances of dying by suicide

[00:02:43] in the first few weeks of treatment or dose escalation, then the medicine that does

[00:02:48] not carry an increased risk of suicide and has far better evidence in preventing suicide

[00:02:54] in lithium.

[00:02:56] The anti-suicide and actually anti-homicide and anti-violence effects seem to be related

[00:03:02] to a reduction in impulsivity.

[00:03:05] Or if you want to think about it in terms of the mind or the subconscious's relationship

[00:03:10] to the conscious self or the frontal lobe, on lithium we're more likely to consciously

[00:03:16] consider our thoughts and emotions before acting on them compared to off of lithium.

[00:03:23] This is likely why we also see better outcomes in detox and addiction treatment settings

[00:03:28] when low dose lithium is used, a major topic of discussion for this series.

[00:03:33] And in the last couple of decades research on the benefits of low doses has exploded

[00:03:40] with inquiries into its role as an immune booster and antiviral, with mounting evidence

[00:03:46] and explanation on its impact in reducing the incidence and severity of COVID infections,

[00:03:54] herpes simplex virus outbreaks or cold sores, boosting the CD4 counts of HIV patients

[00:04:01] and reducing poor outcomes associated with several other viruses.

[00:04:06] It not only has direct antiviral properties, but also helps to modulate or regulate

[00:04:12] the immune system reaction, tamping down the inflammatory immune responses that can overwhelm

[00:04:18] our organ systems due to immune debris or clutter and also indicating a possible role

[00:04:25] in autoimmune conditions.

[00:04:27] Low dose lithium is additionally being investigated as a neuroprotective agent with potential benefits

[00:04:33] in preventing the progression of several types of dementia including Alzheimer's dementia

[00:04:39] and vascular dementia or repeated strokes, chronic traumatic encephalopathy's progression

[00:04:46] towards dementia and other neurodegenerative conditions.

[00:04:51] The list doesn't end there.

[00:04:53] Other researchers have concluded significant cardiovascular and musculoskeletal benefits,

[00:04:58] a protective role in diabetes and obesity, improved sleep and energy, and a preventive

[00:05:05] effect in headaches and migraines.

[00:05:07] Lithium is by no means a panacea for everything, but my favorite part about this treatment

[00:05:14] is the extremely low risk profile of low dose lithium and the near zero risk profile of

[00:05:21] supplemental doses of lithium.

[00:05:24] Intent potential benefit with very limited risk is the type of risk benefit profile I'm

[00:05:30] looking for when choosing to recommend a medication to my patients.

[00:05:35] And as the data continues to emerge on the severity of the risk profile of both the short-term

[00:05:41] and long-term side effects of the main class of antidepressants, the SSRIs, lithium, a safer

[00:05:49] and more effective alternative, which has actually been there since before the SRI roll-out

[00:05:54] appears as an increasingly attractive alternative.

[00:05:58] We're also less in the dark on lithium's many mechanisms.

[00:06:03] As everyday dedicated and mostly conscientious scientists are doing more bench work research

[00:06:10] to learn more about how lithium exerts all of its beneficial actions and deepen our

[00:06:15] understanding of lithium's ionic effects, effects on second messenger systems and effects

[00:06:22] on genetic changes impacting how our intracellular machinery responds to and reacts to its environment.

[00:06:30] Unfortunately, our system prioritizes financial gain, oftentimes at the expense of our health

[00:06:37] and it is sad and frustrating to see how the interconnectedness of the government regulatory

[00:06:43] systems, drug makers, the media and medical research entities restrict widespread access

[00:06:51] to useful data and information and create barriers such as fear to using cheap and natural

[00:06:58] remedies like lithium for suicidality or even COVID.

[00:07:03] It's infuriating that there's not more motivation to research lithium use in COVID that

[00:07:09] my guest on this series had to work with Spanish scientists to study lithium's effectiveness

[00:07:15] against COVID in even a very limited number of patients admitted to the hospital with COVID,

[00:07:21] despite him living and working in New York City.

[00:07:25] With some of the most prestigious research institutes in the world, I've yet to see any

[00:07:30] evidence against its use in COVID or highlighting its ineffectiveness but I wouldn't be surprised

[00:07:37] if the concept of using lithium to prevent or mitigate COVID risk gained enough traction

[00:07:43] via alternative media sources that a large meta-analysis or randomized control trial refuting

[00:07:50] its effectiveness emerges at some point in the future.

[00:07:54] The same game that the industry and government regulators played with the risks associated

[00:07:58] with smoking tobacco or nicotine products will inevitably play out over and over again

[00:08:04] in our society, which is that they know they don't have to convince us Americans that

[00:08:10] their positions are correct.

[00:08:12] All they have to do is cast a significant amount of doubt and produce an adequate amount

[00:08:17] of, quote unquote, controversy to get their desired effect.

[00:08:22] I'm excited to have Dr. Sadear Gad, MD, on to talk about low dose lithium today.

[00:08:28] Dr. Gad is a scientist, physician, and board certified psychiatrist, runs a private

[00:08:34] practice in Manhattan and serves as the medical director for the Center for Recovery and

[00:08:39] Wellness in New York City, ranked in the top 1% of recovery facilities in New York State

[00:08:46] and helps thousands of patients in their recovery from substance use disorders every year.

[00:08:51] He is a commander in the US Navy Reserve and is the founder of Third Element Water, a supplement

[00:08:57] powder containing nutritional lithium along with several other essential and sometimes

[00:09:03] depleted nutrients.

[00:09:05] Dr. Gad is one of the most knowledgeable experts on low dose lithium to optimize mental and

[00:09:10] physical functioning, and has published his research in peer reviewed journals on addiction

[00:09:16] and lithium to enhance COVID recovery.

[00:09:18] He has spoken in wellness and academic circles, appeared on several talk shows, podcasts

[00:09:24] and interviews, and most recently spoke at the Carolinska Institute in Sweden which awards

[00:09:30] the Nobel Prize in Physiology or Medicine annually.

[00:09:34] His comprehensive approach encourages patients to accept their innate value but demand and

[00:09:39] achieve improvement nonetheless, supporting healthy behavioral enhancements encompassed

[00:09:45] by the acronym OLDIS which stands for Occupation, Love, Diet, Intoxicance, Exercise, and

[00:09:54] Sleep.

[00:09:55] His self-stated mission is connection, sacred and secular, prevention and treatment, logic

[00:10:02] and emotion all towards the symbiotic that is the way.

[00:10:08] Today he joins me to discuss his personal and clinical experiences, lithium's role as

[00:10:14] an antiviral and his research on improved COVID-19 outcomes in patients on lithium versus

[00:10:21] not on lithium.

[00:10:23] We talk about why it is severely underutilized as a medication and treatment, and discuss

[00:10:28] our own personal experiences with taking low dose lithium.

[00:10:32] We review some previously discussed historical background on lithium, then segue into its

[00:10:37] benefits in recovery from substance use disorders, as well as low dose stimulant treatment of ADHD

[00:10:44] in the addiction setting.

[00:10:46] Then as most of my guests and I tend to do, we gravitate towards discussion on how to rectify

[00:10:52] the current system we are operating within, and Dr. Gad emphasizes the importance of campaign

[00:10:58] finance reform in electing conscientious officials that will actually do the job we've elected

[00:11:05] and paid them to do, which is move society towards progress and away from a singular focus

[00:11:12] on securing more money for their own future campaigns or retirement accounts.

[00:11:18] He ends with a few closing thoughts and a pretty good mix created by Sudiers Alter Ego,

[00:11:24] DJ Dr. Gad.

[00:11:26] In eclectic synthesis of EDM, hip hop and Bollywood, I hope you enjoy our conversation as much

[00:11:33] as I did.

[00:11:34] Disclosure.

[00:11:35] Dr. Gad is the founder of Third Element Water and has a significant financial investment in

[00:11:40] the company.

[00:11:41] While he does promote it within this series, he also emphasizes that he doesn't care how

[00:11:46] people get their lithium supplement.

[00:11:48] He just wants more patients and providers to recognize its potential benefits.

[00:11:53] Let's dive in.

[00:11:56] Today on the podcast, we have Sudier Gad.

[00:11:59] He works in private practice and at the Center for Recovery and Wellness in New York City

[00:12:05] working in the field of psychiatry for about 20 years.

[00:12:09] I stumbled across your initial work with Lotus Lithium in the detox addiction setting because

[00:12:15] I was already doing it because I have a lot of faith in lithium or at least a lot more

[00:12:20] faith in lithium than most of the other drugs I'm told to prescribe.

[00:12:25] It was pretty cool because I read your paper, I saw the results that you were having and

[00:12:30] then I looked for your contact information and literally the first number that I found

[00:12:36] I called it thinking, oh, I'm going to get somebody or a clinic and you answered the

[00:12:41] phone.

[00:12:42] I was like, oh, how's it going?

[00:12:45] People are still taking a back by that.

[00:12:47] I think it could be a good problem to have when it becomes a problem.

[00:12:51] I think access or at least ensuring that patients have that access actually leads to a reduction

[00:12:59] in their anxiety and less calls oddly enough.

[00:13:04] Is your program a 28 day or a 30 day program both even longer actually?

[00:13:10] We help people as long as they need to be there, helping with housing and vocational educational

[00:13:15] existence.

[00:13:16] I guess what you call long term, there is no exit imminently at 28 days.

[00:13:22] Is it all under the same umbrella group?

[00:13:26] It is yes.

[00:13:27] Even after patient is discharged we continue to work with them and that's what has really made

[00:13:33] us pretty successful.

[00:13:35] Is that continuity of care and a holistic kind of care that bridges evidence based and

[00:13:42] this nutritional realm?

[00:13:44] Yeah, I think that's one of the biggest struggles that I have in my position is that once

[00:13:48] they finish with us we have partners that we utilize in terms of sober living and outpatient

[00:13:55] but it's not typically under the same umbrella and I find myself trying to make sure I reach

[00:14:01] out to as many of those providers that are taking over people's care because they look

[00:14:08] at you with a lot of skepticism when you say that you're going to use lithium to help

[00:14:13] somebody in recovery.

[00:14:14] Yeah, and that's where you want to get comfortable in practicing this talking point or calming

[00:14:22] point of saying this is not lithium for bipolar disorder.

[00:14:26] I'm not recommending that.

[00:14:28] We're talking about the nutritional level and version.

[00:14:32] It's called low dose lithium, it's also called nutritional lithium.

[00:14:35] It's already in us.

[00:14:37] It's in the best soil and water in the world and it's now a more proven, not just historically

[00:14:44] but scientifically proven inflammation mediator especially neurologically than ever before.

[00:14:52] Would you, by chance, give us a little rundown of your professional background in training?

[00:14:58] I started NYU in undergrad and then I went to St. George's which is in Grenada for medical

[00:15:04] school and then back to the States at Stony Brook where I did my residency and then back

[00:15:10] to NYU to be in attending and at Bellevue, talk there as well, join the Navy, continue

[00:15:17] to work with them in the reserves and continue as a medical director and a variety of facilities

[00:15:23] doing research and also conducting my private practice.

[00:15:27] So here I am now after being in institutions and also working as an under big umbrellas

[00:15:33] and under my own, I am very comfortable with these spectrums of illness but also I've

[00:15:40] seen what's behind curtains.

[00:15:42] And I think that is what gives me confidence in this method but also keeps me open because

[00:15:48] there's more good stuff coming.

[00:15:50] Yeah, we've got to be open.

[00:15:52] We cannot anchor on our own biased opinions.

[00:15:55] What did you want to be in high school?

[00:15:58] Did you grow up in the New York area?

[00:15:59] I did out in Long Island as well as Queens and I've been set on being in medicine but

[00:16:06] I think that the kaijiri was not what I was thinking about when I went to medical school

[00:16:11] and enjoyed every part of it and still remained pretty curious about every part of it but

[00:16:16] certain experiences were formative and pushing me into psychiatry.

[00:16:20] One of those was 9-11, others were my experiences in institutional settings working with those

[00:16:27] patients and seeing how important but also how dark the body of knowledge was.

[00:16:35] So I think that combination made me think I would probably do the most good.

[00:16:39] I don't know if I do as well.

[00:16:41] Clearly, I think we're suffering in this country because we don't put emphasis on the importance

[00:16:46] of mental health from insurance perspectives.

[00:16:49] If we don't pay doctors through that you're not going to get doctors going into that

[00:16:54] and you're going to get better financial gains at the end of that when you're intervening

[00:16:59] surgically or with devices but not with your time.

[00:17:03] Did you know that 11.5% of US medical graduates go into primary care by far the lowest rate

[00:17:11] in the world?

[00:17:13] The second ranking country, Germany is 25% going to primary care.

[00:17:18] And that's partially probably why we have terrible outcomes in terms of why we're fading

[00:17:24] as well.

[00:17:25] I know that you did DJ or you did DJ at least in the past I would love it if we could feature

[00:17:30] some of your work and I'd love to hear more about how you got into that.

[00:17:33] It's a fun hobby to orchestrate a party, you're reading minds in a different way for

[00:17:39] fun and trying to get people to dance.

[00:17:41] As long as hands are in the air that's all that matters.

[00:17:44] Though I was collecting a lot of vinyl and when I put it on at home it seemed to be nice

[00:17:49] for people so I kept doing it and so I've been asked to do it at certain parties and events

[00:17:53] and some are notable and I'm very confident in what I do and keep up to date.

[00:17:59] It's fun.

[00:18:00] I've managed to produce some music, some mixes with folks in Atlanta.

[00:18:03] So I'm happy to share that.

[00:18:05] I'm on SoundCloud.

[00:18:06] It's DJ Dr. Gad, made some nice mixes there for people but I'm happy to send you some

[00:18:12] mixes and you can apply it.

[00:18:14] It's a nice little hobby.

[00:18:15] It's not going to be something I do.

[00:18:18] Yeah.

[00:18:19] Hey take out the social anxiety involved.

[00:18:21] I've never really met somebody who didn't have a smile on their face when they're dancing.

[00:18:27] Outside of the fear of retribution that somebody else will think what I'm doing is weird.

[00:18:32] It's one of those simple pleasures in life.

[00:18:35] I've thought about and I haven't been willing to go out on the ledge and take the leap

[00:18:40] but of bringing my boom box into my treatment facility on but day where there's extra

[00:18:45] time and just going into the millions saying hey let's turn on some music and let's have

[00:18:51] some old fashioned fun.

[00:18:53] Let's get that dopamine hit without having to hit anything.

[00:18:57] Absolutely.

[00:18:58] I would recommend you make your playlist and let it rip in there.

[00:19:02] I'm fine because it is absolutely primal.

[00:19:07] Anything else personally that you do for fun or that really helps you get away from all

[00:19:11] of the work stuff?

[00:19:13] My family is very important to me.

[00:19:15] I love spending time with them and frankly it was nothing I'd rather do but keeping yourself

[00:19:19] mentally and physically in shape is so important.

[00:19:22] So I try and do that whether it's running biking, lifting.

[00:19:27] And yeah I think that about rounds it out.

[00:19:30] I'm talking about lithium a lot and you know that requires rest and just some wholesome

[00:19:38] habits.

[00:19:42] Somebody get this guy some help.

[00:19:51] Thanks for listening.