9.4 Low-Dose Lithium: Solutions, Closing Thoughts, and Song

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

[00:00:12] Yeah and honestly the sentiment that you kind of displayed they're talking about that is

[00:00:16] the impetus for starting this podcast.

[00:00:19] I thought it was absolutely insane that I was told to prescribe to the suicidal patient

[00:00:27] a class of drugs that in the first couple of weeks can make them more suicidal and more

[00:00:33] likely to harm themselves or kill themselves but nobody ever talked about using even low

[00:00:40] doses of lithium to help prevent people from killing themselves.

[00:00:45] The worst outcome that we can have in the field of psychiatry and I saw a lot of the

[00:00:51] same problems when COVID happened and this is not just psychiatry in my opinion it's

[00:00:58] our entire medical system instead of relying on preventive and safe measures using tried

[00:01:06] and true medications or treatments we so often try to treat symptoms of diseases as opposed

[00:01:15] to modifying the disease itself and that frustrated the absolute crap out of me which is

[00:01:23] why I had to start doing this because I needed an outlet to feel like I could talk to people

[00:01:28] about some of these issues that I saw and that to a point can really bring you down.

[00:01:35] I think if I didn't start taking a lithium supplement a couple of years ago that it would

[00:01:41] be all too frustrating to keep trying to plug away and day in and day out see what kind

[00:01:48] of impact I can make on my field as a pawn in the field of psychiatry essentially.

[00:01:53] Yeah, I don't know how some other people do it man.

[00:01:55] I give you credit to talking about this you call the rebel or radical component of this

[00:02:01] radical means root right it means to the root and that can be asked me Jesus is a radical

[00:02:08] if we're not going to get to the root then we're just going to keep playing whack them

[00:02:11] all in medicine that is exhausting and it's not so satisfying I think the best healthcare

[00:02:18] is not needing it.

[00:02:19] And doctor really again another word etymology your doctor the word it comes from the word

[00:02:24] for teacher so are we really teaching today or are we simply judging they come in we

[00:02:31] make a judgment we give this medicine we bill goodbye that wasn't the medicine I wanted

[00:02:36] to practice I wanted to help people who came to my office voice their frustrations but

[00:02:43] also continue what we need to continue now but then help them find a way off of it the

[00:02:48] battle we're talking about is reversing about 100 years of corrupted government and industry

[00:02:56] that is now it's become metastatic they're just absolutely feeding off each other.

[00:03:02] I love the way that you talk about the impact on individuals the impact on the middle

[00:03:08] class the fact that we are selling people health care that is ungodly expensive compared

[00:03:15] to the rest of the world with really piss poor outcomes people don't realize in America

[00:03:21] that our life expectancy drags four years behind other developed countries we pay twice

[00:03:28] as much for our health care to get worse results it's hard to see a way out I've got

[00:03:35] to remind myself that there's a lot of individuals that I interact with and that is really important

[00:03:40] I understand systematically why lithium is so underutilized and you've touched on a few

[00:03:45] of those components it's natural there's no money to be made on it I can prescribe

[00:03:50] a 90 day supply of lithium to a patient without insurance and they'll pay eight dollars

[00:03:57] what do you think is the way out other than for you and I talking about this and continuing

[00:04:03] to use this what is the way to affect the system as a whole there is one way out it's campaign

[00:04:10] financial form it doesn't sound sexy but that is what it is similar to this concept of

[00:04:17] lithium in medicine that it's something so obvious so cheap so silly so not futuristic

[00:04:24] right it's not robots going in and cleaning your arteries it's not gene editing it's just

[00:04:30] nature and greed is what has infected this system we're under you mentioned the middle

[00:04:37] class we just need to look at one specific set of statistics you can make a piece sign if

[00:04:42] you're at home you turn it on its side and you've got your middle finger right across

[00:04:47] you've got your index finger going straight up that is the graph of median income which is

[00:04:53] stayed pretty flat since the mid-70s and that rising graph is four different things health

[00:04:59] care costs education costs housing costs and campaign financing directly associated with

[00:05:07] that the people who make the rules that cause us to blame the players who are playing by those

[00:05:14] rules whether it's hospitals insurance big pharma doctors food manufacturers we can ascribe

[00:05:21] blame to all these people which is very common you have a whole industry of people who are

[00:05:27] blaming the food manufacturers blaming pharma blaming industry of insurance but they don't

[00:05:33] see that all those people play by the rules set by congress and now it's worse than ever in

[00:05:39] congress now now they're just blatantly trading stocks you don't even need anyone other than

[00:05:45] to follow Nancy Pelosi's portfolio so it's obvious now it's that blatant I think Democrats

[00:05:51] are still crappier at corruption than Republicans but they're not saying anything about it they're

[00:05:58] not doing anything about it either anymore so they're in complicit as well that's the way

[00:06:03] out we demand that from both sides because we're on the wings there's no one in the cockpit

[00:06:07] anymore that's the way out in the meantime this is exhausting enough for me to just sit

[00:06:12] with every patient every provider and say guys you don't have to give all these medicines if

[00:06:18] you add just a sprinkle of lithium the lowest you want to give the lowest that they can take they

[00:06:24] don't have to take it you can also tell them about the importance of iodine in their diet you

[00:06:29] don't have to take that either right but back in the day we had enough sense to put it into salt

[00:06:34] because we knew people weren't gonna trust it all over we put fluoride into water and these days

[00:06:40] there are problems against that too we put folate into bread we've done these things to reduce

[00:06:47] catastrophic disease and even now we're failing because 10% of the population 20% of the black

[00:06:54] population is deficient in vitamin D we can do our part to talk about lithium as a nutrient not

[00:07:01] a medicine it's both but it's really a strong medicine for people with very severe illness but

[00:07:07] it's a really important nutrient for everyone else I take it myself and that's a selling point

[00:07:13] I tell my patients I take these exactos and it's safe it's useful take it or leave it fry it you'll

[00:07:19] see the effects they can see it in heart rate variability they can see it in REM sleep I talk about

[00:07:26] this with doctors who are pretty high functioning and that's all people need is a little bit of honesty a

[00:07:32] little bit of teaching and for them to question you about it and not hard sell it right that's all

[00:07:39] an economist article said 95% of pharmaceutical money that goes to campaigns goes to winners they

[00:07:48] already know who is most likely to win they line those pockets and then they know they have enough

[00:07:55] people within our government system to be able to do what they want and when we go from spending

[00:08:02] 5% of our GDP on health care back in the 60s to now spending nearly 20% people cannot accumulate assets

[00:08:11] people cannot accumulate wealth generational wealth it's nearly impossible for a lower middle class

[00:08:17] person to accumulate because they're spending so much on their medical bills on their rent their

[00:08:24] food options are really unhealthy processed foods a lot of high fructose corn syrup it's very

[00:08:33] frustrating I'm young in my career I recognize that and I've got a lot to learn and a lot to build on

[00:08:39] but I'm coming out of the gates and I'm trying to fire pretty loudly today is actually the 18th

[00:08:45] anniversary of my mother's death and I look at that a lot differently now it is one of those things

[00:08:54] that drives me to do good just good in the world and it pains me to see that doesn't appear to

[00:09:02] be a driving factor for so many other people in these positions of power and authority at the

[00:09:10] highest levels of government how do we get back to electing folks like George Washington who were

[00:09:17] so highly respected for their moral fortitude above anything else my admiration for your sublimation

[00:09:25] right for how you've taken such a traumatic loss and have honored her in that way I tell patients

[00:09:34] did I'll anger bargaining depression acceptance it's not complete acceptance is not enough if you

[00:09:41] really want to resolve the loss of someone that special that you loved how you honor them not

[00:09:47] with a plaque necessarily but with them driving purpose and so it's really touching right to hear

[00:09:54] that you use our memory to do that and I think we can inspire any professional who has lost their way

[00:10:00] whether it's in elected office or who holds a license for something to keep striving for

[00:10:06] something bigger to sacrifice this gain monetarily temporarily for something deeper so that they

[00:10:16] can sleep at night so their soul is elevated because I don't see any of these people worthy of

[00:10:22] having a portrait up in the house of the senate if this is what they do which is 70% of the time

[00:10:29] asking for money if that's what they're doing most of the time is emailing us and calling us this

[00:10:34] is gotta be soiling to themselves you might be too young to remember but I used to have weekly

[00:10:42] journal club sponsored by pharma right so I could have a lot of Thursdays that was something

[00:10:50] to look forward to instead of cold cuts again in the hospital cafeteria so we go up there and we eat

[00:10:56] watch this lecture feel dirty afterwards because I knew this was skewed information that had a

[00:11:04] kernel of truth and that I was watching it by force it was disrespectful for me to eat and then leave

[00:11:12] and even then that food was just it was then tainted I had to talk to these people I had to listen

[00:11:18] in their lecture we had to be smeared as an entire department altogether and when they told us

[00:11:24] they were taken it away I said shit more cold cup again another day but I think I liked it

[00:11:31] right after when I didn't have to wear their chaach keys when I could look at myself and it was just

[00:11:37] the lab coat and the big pen and not labels everywhere we can actually talk honestly about stuff

[00:11:44] in a collective group and not be spoon-fed drivel you got your dignity back you got a groove back

[00:11:53] this is what we have to implore congress to take back we don't need to elect new people they can do it

[00:11:59] we just demand it and I don't think it's going to happen by force but if we don't it might have to

[00:12:05] this is what we're headed to which January 6 could be a rehearsal based on how tough things are going

[00:12:12] for Americans this is why all those rates of addiction suicide violence mass violence are rising

[00:12:18] people are getting desperate and the access to weapons of destruction are higher than ever

[00:12:25] but means of rising up that ladder are lower this is a bipartisan issue this is not a right wing versus

[00:12:33] left wing there's enough corruption on both ends of the aisle that it's preventing our society from

[00:12:41] progressing take money out of the equation many many many years ago we worked to get better at

[00:12:50] our crafts we worked to be better as a species as a group and we've just totally lost sight of that

[00:12:58] for these superficial monetary and worldly gains and that I think is the biggest thing that drives me

[00:13:06] crazy well seriously thank you so much for your time thank you for your work I would love to have

[00:13:13] an opportunity to talk to you again about some of the mysteries of our field that's something that

[00:13:20] you and I with what we do we have to consciously remind ourselves how lucky we are to be in a field where

[00:13:27] we can be curious about how our own brains function and curiosity and quizzidiveness really

[00:13:34] it's a luxury to have in your work so I'm extremely grateful for that I'm grateful for you

[00:13:39] coming on and doing what you do and I'm just glad that I'm not the only person who's out there trying

[00:13:44] to tell people to use more freaking lithium and that it's not gonna harm you I don't have any side

[00:13:50] effects on these low doses nobody's at a thyroid issue and I think that becomes more relevant as

[00:13:55] you get to 300 and higher I'm sure there will be the person who has a thyroid issue at 150 but

[00:14:01] this toxicity stuff the kidney stuff it's really not relevant on these low doses so thank you so much I

[00:14:09] look forward to hopefully talking to you again I cry to Dr. Sean pleasure and keep it up man you're

[00:14:14] on the right track and I'm happy to be a part of this and to have inspired you and you're doing it

[00:14:20] and it's great that you were already in this space of functional medicine integrated medicine however

[00:14:26] you want to put it and then found something to confirm your stances that is what connected me

[00:14:33] and led me further so I hope you take this and keep digging and keep reading and keep trying perhaps

[00:14:39] write something as well because replicated research is better I'm just recording a few closing

[00:14:46] thoughts a couple of weeks after Dr. Gatt and I spoke I want to reiterate the fact that FDA approvals

[00:14:54] require funding and because lithium is a natural substance it cannot be patented

[00:15:02] and the exclusivity on most drug patents lasts at least 20 years which means that the company who

[00:15:11] funds and runs the clinical trials is the only company that can make that medicine until it becomes

[00:15:17] generic around 20 or sometimes 25 to 30 years later therefore if you and I and Dr. Gatt

[00:15:27] all started a lithium company and we wanted to get it FDA approved for major depressive disorder

[00:15:34] which unfortunately it is not at this point then if I ran the clinical trial which it is very

[00:15:43] expensive to run a clinical trial then you and Dr. Gatt's companies could use my research

[00:15:50] and produce your own lithium medication making it very hard for my company to be profitable

[00:15:56] and very easy for your all companies to be profitable now typically in the past the national

[00:16:03] institutes of health have stepped in and funded the research on these things but the reality of

[00:16:11] lithium gaining FDA approval for unipolar depression or major depressive disorder

[00:16:17] is that it would cut into the profits of so many other drugs the cost of a 90 day low dose lithium

[00:16:24] prescription for my patients without insurance is somewhere between seven and ten dollars

[00:16:31] that's less than 10 cents a pill now that's great for patients and honestly for their insurance

[00:16:38] companies but it's not so great for pharmaceutical companies that have spent millions of dollars on

[00:16:45] research and development of alternative antidepressants so unfortunately they've not funded those studies

[00:16:52] and it is not FDA approved for those conditions however I think we've revealed quite a bit of evidence

[00:17:00] of the FDA's cohesive relationship with pharmaceutical industry with a revolving door

[00:17:08] of high up executives in both entities so I doubt that we'll see that anytime soon however

[00:17:15] I find it unethical and poor practice to not use lithium in suicidal patients if it were my

[00:17:24] loved one that was contemplating suicide I would no doubt recommend that they take lithium

[00:17:30] to reduce the frequency and severity of intrusive suicidal thoughts you see a lot of smaller

[00:17:38] trials with lithium but none of the large randomized control trials that you see with other medications

[00:17:45] conscientious physicians and providers are trying to add to the evidence base

[00:17:51] but individuals can only manage and fund so many patients in a research study

[00:17:58] we need to continue to investigate lithium's role into other potential benefits if it does have a

[00:18:07] significant impact in reducing the severity of COVID infections like it appears to do so

[00:18:15] we need to know at what dose do you get the most benefit and evaluate that benefit risk ratio

[00:18:23] to determine if maybe lithium could be a useful treatment at either preventing or mitigating

[00:18:29] the severity of the infection or the immune response to the infection but this would obviously cut

[00:18:35] into major profit margins for a lot of these companies making billions of dollars off of the COVID

[00:18:42] pandemic it would be one thing if this was an isolated drug and an isolated event in our culture

[00:18:50] but this story just keeps playing out over and over and over again from creating doubt and uncertainty

[00:18:58] that smoking calls lung cancer which we now accept as a certainty to the FDA approval of oxy

[00:19:06] cotton in 1996 to the viox disaster of the late 90s and early 2000s to maqena in the OBGYN world

[00:19:17] to the new Alzheimer's drugs which 10 or 15 years from now we will all acknowledge they didn't work

[00:19:24] and the beta-amaloid deposition hypothesis is incomplete in our understanding of what causes

[00:19:30] Alzheimer's this is happening over and over and over again we have got to stand up for what is

[00:19:37] right what defines making true medical progress in our understanding of what causes and what

[00:19:45] treats disease processes we need to stand by our hypocritic oath to do no harm or at least make

[00:19:55] a better effort at minimizing harm the benefit needs to outweigh the risks i'm not going to tell you

[00:20:02] that lithium is a panacea lithium does not work for everything not everyone experiences all of the

[00:20:10] different potential benefits of lithium and it can be associated with significant side effects

[00:20:17] especially at the higher doses used to treat bipolar disorder in which there is a risk of

[00:20:23] toxicity which is very serious a risk of kidney disease which takes a long time to develop even in

[00:20:31] that bipolar disorder population on high doses and most relevant to low doses the potential for

[00:20:38] thyroid resistance and disease which again does not occur as frequently on low doses and goes away

[00:20:46] with cessation of treatment but is still a factor to consider on the wrist side of things ultimately

[00:20:54] this podcast is about unmasking the corruption that occurs in our medical system it's about

[00:21:01] appreciating the nuance and uncertainty that all good clinicians must navigate in making

[00:21:08] appropriate clinical decisions with their patients hopefully this series illuminates some of

[00:21:14] those themes and for patients gives you alternative options that you can take to discuss with your

[00:21:22] provider and for providers hopefully this peaks your curiosity to do your own investigations into

[00:21:29] low dose lithium to read the ancient evidence of its impact to read the medical research that goes

[00:21:36] back into the 1800s and to read the most recent research on all the potential benefits of low doses

[00:21:44] ultimately most of us want to help our patients in the best way possible and if you feel stuck especially

[00:21:51] in the area of psychiatry if you feel like your patients are not getting significantly better or

[00:21:59] only seeing superficial short-lasting temporary improvement in their conditions maybe it's time

[00:22:05] to look elsewhere we can positively impact our system but we have to work together in large numbers

[00:22:14] in order to instigate change we have to demand that change we have to fight for that change

[00:22:20] we've got to move our society forward towards progress maybe even at the expense of profit stick

[00:22:29] around after the disclaimer to hear one of DJ Dr. Gads mixes and I'm probably botching the pronunciation

[00:22:37] but it's called apni jace remix available on soundcloud DJ Dr. Gad or DJ Gadisa GADISA hope you enjoy

[00:22:51] somebody get this guy some help

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[00:23:24] thank you disclaimer this podcast is for informational purposes only the information provided

[00:23:28] in this podcast and related materials are meant only to educate this information is not intended

[00:23:31] as a substitute for professional medical advice while i am a medical doctor and many of my guests

[00:23:34] have extensive medical training and experience nothing stated in this podcast nor materials

[00:23:38] related to this podcast including recommended websites text graphics images or any other materials

[00:23:42] should be treated as a substitute for professional medical or psychological advice diagnosis

[00:23:46] for treatment all listeners should consult with a medical professional licensed mental health

[00:23:49] provider or other healthcare provider if seeking medical advice diagnosis for treatment or put more

[00:23:53] simply you need help like this guy call your own doctor