Interview with Potomac Psychiatry; Dr. Bruce Kehr and Nutritionist, Julie Wendt

Today I'm interviewing Dr. Bruce Kehr and Nutritionist, Julie Wendt about root cause psychiatry, the role of nutrition in your treatment, and your mental health and diet and how it relates to your chronic illness. Potomac Psychiatry does whatever it takes to help each patient achieve a a full recovery from their suffering. This award-winning practice has improved thousands of lives. Instead of taking trial and error approach to your health, they offer a personalized treatment roadmap to better emotional wellbeing based on your unique history, genetics, needs, and goals. Through Precision Psychiatry, they help you feel better, faster.

Transcript

 Hi, this is Brandy Schantz and you're listening to Living Chronic. Today I'm speaking with Dr. Bruce Kehr and Julie Wendt, nutritionist from Potomac Psychiatry. And I'm really excited about today's episode because we're gonna learn a lot about, uh, you know, holistic health. Everything that I'm always talking about.

It's everything that you do, it's everything in your life. So I'm really excited. Uh, so welcome Dr. Karen. 

Thanks Brandy. Thanks for inviting us. 

So I'll start out, um, I've read a lot about your practice. It's really exciting to learn about some of these things. Uh, so my first question is, you know, you do root cause psychiatry.

What is 

that? Um, well, root cause psychiatry is a way of helping people with mental health problems where. Don't simply take a history, uh, and understand symptomatology and prescribe therapy and medications. What we do is we go deeper and we try to understand what's going on in the main building blocks of mental health.

So when we look at the main building blocks of mental health, there are, uh, four categories, um, matter. Energy information and conscious awareness. So matter relates to things like how, uh, our cells are composed, what they're comprised of things, uh, levels of amino acids and proteins, and, uh, how micronutrients play a role and oxidative stress.

Um, Uh, energy has to do with mitochondria and ATP production, along with other sources of energy production in the cell. What's going well and what isn't? Then we look at information systems in the body. The body is this vast information complex, obviously beginning with the 25,000 genes that we have in each and every cell that are the way that the body and the cell's blueprint.

All cellular activity, and then we look at the epigenome, all of the different epigenetic factors that can influence whether a gene is expressed or not expressed, turned on, or turned off. We'll look at the gut microbiome. We'll look at methylation, we'll look at many other factors, and then what we'll do is we'll build a very personalized, unique database for each of the patients in the root cause program.

and one by one we address each of the data points that are contributing to mental health problems. And what I'll do is I'll screen share a kind of overview of how we do this. Um, I've got a share button pressed. Okay. And just make sure it works.

Here we go. If you could please let me know when you see this. 

I've got 

it. Great. So what we have here is we have, uh, a systems diagram of, um, our human body and you'll see, um, in the upper left inflammation, what we find is that inflammation often is a root cause of a number of chronic. Mental and physical health issues.

And so the question becomes where does that inflammation derive from? It could be insulin resistance, it could be a poor diet, it could be environmental stress, it could be toxicants like heavy metals or, uh, glyphosate or, uh, microtoxins, hormone imbalances, sleep apnea syndrome. There are many possible, uh, genetic.

There are a number of. Drivers of inflammation. We know that when there's systemic inflammation, it begins to cause brain inflammation, gut inflammation, and dysbiosis. It activates over here with stress, chemistry, the adrenal glands, putting a lot out, a lot of, uh, adrenaline and cortisol. And then we can, and many of our patients begin to see problems with the immune.

We have, uh, innate immunity that, uh, is not working as well, which predisposes to infections. And then in some patients, the adaptive immune system in the lower right begins to be affected. And we have what are called hollow cavity infections like asthma, sinus conditions, urinary tract infections, and then in some, ultimately autoimmunity.

So part of the work of at times might. Looking at other elements, other domains here, such as the immune system and infectious diseases. 

That's fascinating. Um, I think so many of us really can relate to that. I'm just looking at the graphic and I think of some of the issues that I've had and it makes sense to me that it's all interconnected.

So I've also read, you know, more about, a little bit about genetics. What role do genetics play in mental health? 

Well, there are basically three kinds of genes that we test for, um, with two different companies. Genomind is one, and in Intes DNA is the second with a Genomind test. We look at what are called pharmacokinetic and pharmacodynamic genes.

The pharmacokinetic genes look at how different medications are metabolized in the.  and help us predict whether someone really needs tiny, tiny doses of a medicine, otherwise they're gonna have side effects. Or maybe they need higher doses because they break down that medicine very rapidly. The pharmacodynamic genes are genes that point toward certain systems in the brain that affect mental health.

Things like, uh, Mt. H ffr, which is a methyl. Gene that helps determine serotonin and no dopamine, norepinephrine levels or homocystine levels, which is a pro-inflammatory molecule. Um, calcium channels and sodium channels, these channels that help determine firing rates of neurons. So that test helps us really mainly around prescription medications and how to select the right ones and properly dose them.

It has this really cool. Drug interaction tool where we can input not only the psychiatric meds, but all the other meds, prescribe other doctors and look at interactions, drug drug interactions, interactions between the genes and the drugs. And then with Intes DNA is this marvelous tool with over 700 genes.

And what that looks at is how do different genes. All sorts of systems in the body, things ranging from o c D, anxiety, depression, uh, brain fog, brain inflammation, coagulation, many, many different, uh, uh, Alzheimer's and other dementia related genes. And this is where Julie's work really becomes extremely important because each of these genes in Intel's dna.

Are upregulated or downregulated turned on or turned off based upon nutrient and supplement related interventions. And the science is wonderful. It's fully transparent. The company lists every single reference, so it's not, you know, voodoo science, you know, it's based in real peer reviewed journal articles that just keep expanding.

So we do a lot of work with both of these. Genetic, uh, testing companies. And maybe Julie, you might have some more to say about, uh, how, how you work with that test cuz you've studied, uh, ne nutrigenomics. 

Yeah, so I think, uh, that's an interesting point to make, which is these are looking at.  genetic variations that we can impact with nutrition and, and lifestyle interventions.

Mm-hmm. . So everything is very much targeted towards diet and lifestyle change to support optimized health. And it's also our, one of our keys to really being able to personalize. The treatments that we recommend because we can, for example, look at the M T H F R variation and understand that, you know, given your particular genetics, We're, they're going to have an issue taking folate from foods such as leafy greens and converting it into the active form to help run that methylation cycle, to provide those methyl groups that allow for the neurotransmitters to be produced, among other things.

Um, so that's where we can. Help, prioritize and advise on very specific diet recommendations when we pair genetic s n p understandings with, uh, blood test results to kind of, um, assess inflammation and, and how your body is, um, working with the diet and lifestyle you currently have, and where we can make enhancements to help harmonize everything and get everything working more smooth.

And, and while we're on the subject of methylation, let me, cuz this is really a critical aspect of life itself. I'm gonna screen share another infographic. Please let me know when you can see this. 

Okay. We have the methylation chart. 

Great. So methylation is, um, a hugely important cycle that takes place inside every cell of our body.

You know, 30 trillion cells, human cells inside our body, we have 90 to a hundred trillion microbial cells that we coexist with. And if we look at, on the right hand side here, the outputs of methylation, we have Sial, methionine, or Sammy. Lots of people probably know about Sammy. This is a universal method donor.

This is one of the two main ways that genes are expressed and mainly. This methyl donor turns off genes that need to be quieted down. And if we have these M T H FFR variants, we're not producing enough Sammy. So the very gene regulation of pretty much every gene in the body is negatively affected. The other thing that happens is we get these elevations of homocystine, which cause brain inflammation.

They affect what are called the endothelial lining. Of the, uh, vessels in, in the body and the brain, so it can begin to create problems with things like micro clots. We don't create new neurons in the hippocampus of the brain. We create a lot of glutamate, which is excitotoxin. We don't produce enough serotonin, dopamine, and norepinephrine, and we don't produce enough Glu glutathione, which is a very.

antioxidant in the brain, which also downregulates glutamate, which is exci toxic. So these, uh, and we test, we assay for, uh, multiple different between the two genetic tests, multiple different variants of, uh, methylation genes to help see if we have a problem here. And then we have a medical food like end light that we can give that provides all these micronutrient.

shown here in Brown. So this is another way of, of looking at, you know, root cause. Mm-hmm. , psychiatry from a cellular, uh, mechanism and, uh, uh, you know, a deep knowledge and understanding of molecular biology and cell biology. 

This is fascinating. Um, it really rolls into one of my biggest questions today. Um, I heard you talk about brain fog a bit earlier.

I suffer from it myself. Um, I have for a while now, and I often tell people just, you know, just because you don't have a an autoimmune disease does not mean you cannot be chronically ill. And I've had a lot of people come on the show who didn't necessarily think of themselves as chronically ill until they took a different look at what they're suffering from in their life.

And many people right now are suffering from long covid. I actually was just diagnosed with it myself on Thursday. And was told a lot of my brain fog is probably coming from that. So I'd love to hear more about, um, brain fog and how nutrition can help with that. 

Let me just, if I may, Julie, just jump in around some of the pathophysiology of long covid and brain fog, um, and then I'll turn it over to you.

For, for nutrition. So there are a number of possible causes of long covid and, and the really, I guess I hesitate to put it this way, but maybe one of the positives that's coming out of Covid is it's helping us understand the mechanisms of other chronic illnesses like me, cfs. Mm-hmm. , like fibromyalgia, like pots and dysautonomia.

What we're learning is that a number of different infectious diseases, including covid, may have a common endpoint in the body in terms of causing these problems. So it could be caused by strep, uh, tickborne diseases such as lime, uh, Bai, barella, uh, many other microorganisms, including the coronavirus.  and the underlying problems can range from a persisting reservoir of the microbe in the body that is either cloaked from the immune system or has effectively neutralized the immune response.

Um, another finding is that fragments of the microbe can persist.  and persist as antigens triggering an immune response. So for example, Bruce Patterson and in Cell Dx has documented really exquisitely that fragments of the spike protein can remain in monocytes, which are part of the innate, uh, immune system.

Monocytes typically die off in a week. These monocytes they live on from now, uh, they've been found to live on for two years with these spike. Still inside that they can't seem to get rid of. The other really important, uh, causes that are emerging are, uh, endothelial where there's an inflammation in the lining of the blood vessel walls, these monocytes, uh, predispose of that and then attract platelets and cause these micro clots.

Um, and the, the, the monocytes that enter the surrounding tissue, it's another possible, uh, cause.  and then an area that Julie is exquisitely familiar with in terms of evaluating, treating. Um, most of these patients have gut microbiome dysregulation. Uh, so much immunity begins down there. So part of what we do in, in our, our long covid program is evaluate these various causes.

It is an evolving field. There's, uh, a lot of knowledge that's being created almost daily. . So it's sort of like we, we think of it as we're flying the plane while we're building it. So, and we welcome collaboration if, you know, patients come upon new research. Um, but that's how we look upon a lot of these chronic conditions.

What, what I think a lot of scientists are finding is multiple different triggers, but a kind of final common pathway causing the symptoms. Mm-hmm.  without. Mm-hmm. . Julie, if you will, you please talk about the. Sure. 

So, um, brain fog, as we know, can show up as a result of multiple different underlying conditions.

And so when I'm looking at it from a nutrition perspective, I am kind of triaging how I want to help sort what's happening for this particular patient. Um, I do that using testing to help understand more specifically what's happening with, for example, the gi. Health and the integrity of everything about your digestive system.

So we can look at your digestive enzymes, we can look at your microbiome, make sure that there aren't any, um, pathogens or overgrowth patterns that are creating an environment within your GI tract that is inflammatory in and of itself and as the GI tract.  becomes inflamed. What happens? Um, somewhat known as intestinal permeability or leaky gut.

Mm-hmm. , either one, interchangeable, but basically the integrity of that barrier is compromised. And instead of us having a very selective process for what particles enter into our body, , we kind of have the barn doors open, , and we're getting all sorts of things interacting with our immune system. Um, crossing over into the blood brain barrier and creating, um, an environment that is endotoxin.

So, Part of what I like to do is focus in on sort of that foundational aspect of health and make sure that the foundation is in good shape. So looking at intestinal permeability, helping to, uh, normalize and optimize the gut microbiome so that from that perspective, our foundation is strong and. . When I add to that this idea of, um, cellular energy and cellular health, thinking about your brain cell being just like a cell in your heart is going to need to produce energy in order to fuel its cellular machinery.

So, , what are we doing from a micronutrient perspective to make sure that we have all those raw materials that we need? Mm-hmm. . So we saw in that great chart that, um, is one of my favorites. We saw all those co-factors, the B vitamins, the zinc, magnesium, iron, et cetera. Um, and in addition to that, you know, thinking about.

what do we want in the diet? What do we wanna try to take out of the diet? What would be considered, um, sort of pro-inflammatory eating patterns? Mm-hmm.  to make sure, you know, the patients are moving away from that. Because while it might not have. Caused the initial, um, insult. It certainly is going to either perpetuate or make worse, um, some of the symptoms that are coming as a result of something like long covid.

Okay. 

And, and, uh, thanks for bringing up mitochondria. Um, Julie, Brandi, let me just screen share another infographic that I think really helps illustrate what Julie was talking about. Just please let me know when you can see it. Look at it up. Great. So, uh, I think pretty much, uh, most of the people who follow you, Brandy, understand that the mitochondria are the power plants of the cells.

Mm-hmm. , um, and, uh, they really have many, many more. Roles beyond that, uh, involved in synthesizing helo globin, which obviously carries oxygen, every major hormone in the body. Uh, phospho lipids, which make up membranes around the mitochondria themselves and around all cells. And then they're very heavily involved as a kind of sensor system in the body, helping to regulate immune system functioning.

Uh, oxygen levels in the tissues, sensing blood sugar levels. Um, and they are constantly in communication with, uh, the DNA inside the nucleus of all the cells. There's a, a signaling going back and forth, and they have their own, um, DNA n inside the mitochondria. So interestingly, the brain related to brain fog.

while most cells in the body have a few hundred of these mitochondria per cell in them mm-hmm. , many brain cells have millions of mitochondria per cell because the brain has to produce so much energy to function properly. So the brain has to be a huge energy producer cuz it's a huge energy consumer.

And so the kind of work that Julie does to first understand what's going on in terms of mitochondrial function and oxidative. Methylation, which affects mitochondria function. And then providing a, an an an information based test, results based approach to enhancing mitochondrial function is really important.

That's, that's so great to learn about. Of course, you know, i b d patients, myself included, I have Crohn's disease. We're very familiar with restrictive diets, specific diets. Um, of course, if I, you know, ever ask my husband to go on a specific diet, he loses his mind at, you know, having that much structure.

But we're, we're quite used to it at this point. Um, anybody who's had I b D for a certain period of time know, . And of course with that, just because you're used to it doesn't mean you don't experience some depression and anxiety around that. Whether it's anx anxiety over whether you'll have something to eat when you go somewhere or some depression because you know everybody else is having pizza and you're having side salad when you go out with friends.

Um, and then of course, We also sometimes have to go on an all liquid diet, usually during flares. Um, that's my least favorite. It's probably the diet that I just hate the most. Um, so do you have any advice for patients who are on a limited diet or a liquid diet and you know how they can cope with that and all of the emotion that comes with it?

Julie, you wanna take that one? 

Sure. Um, yeah, I mean, first of all, I think what's important is to be able to verbalize and, and get that out there because I think a lot of times we're suffering and we don't share it and it makes the suffering worse, right? So I really like to, um, have those types of dialogues with my patients because I think.

just that can be healing, right? Mm-hmm. . And also, you know, as you talk about this type of thing, we start to understand what types of solutions are actually gonna be more meaningful then, um, otherwise, right? If we don't understand where it's coming from precisely the, the turmoil and the stress, then it can be hard to create a solution.

Um, When I think about the types of solutions that seem to work best in those circumstances, it's really this mindset shift around why and understanding your why, and being clear about that and knowing that there's, this is the journey that you're on and you know, not maybe understanding.  why you're on the journey, but just knowing that this, this is what you're faced with right now and other people are on other journeys, right?

Right. And so being able to care for ourselves in a way that's, um, knowledgeable, right? We know the types of foods that are healing and, um, gonna get you into a better spot in keeping this very individual, um,  mindset in place I think helps the keep at bay some of those feelings of being left out. Mm-hmm.

And then I also.  like for people to plan for success in some ways by surrounding themselves with people that understand, right? So it might not be the right time to go out with a new group of friends where you're gonna have to discuss all the details. It might be, okay, let's plan things with friends and family that kind of know what's up and, and aren't gonna give like a weird vibe if I'm eating something different from the group.

So kind of setting yourself up in that way to, um, Be in a supportive environment can also really help shift how it feels for you. 

And you know, this, um, that's a really beautiful answer, Julie . Um, the other thing we find is that, um, there's this phrase, uh, uh, one of my patients use with with family members and friends.

It's not me, it's my dna. . Oh. So for example, there are many different genes that, um, affect these kinds of gut related issues. So, for example, in the inte DNA panel, there are genes, uh, related to, um, uh, there there're, there are pro-inflammatory genes. There're genes related to foods that contain histamine, that can excessively activate gut related problems.

there are a variety of, uh, HLA related, uh, genes related to the ability of the gut to, uh, break down a gluten. Um, there are other tests we can look at where we can, uh, assay a variety of different foods that predisposed to causing gut, uh, permeability. And causing blood-brain barrier, permeability and sort of tying together the two that the foods, you know, not only sensitized the gut and inflame the gut, but also then activate the immune system and break down the blood-brain barrier.

So to have that kind of explanation and knowledge and understanding, and look, I was born with this. Mm-hmm. , right? I didn't ask for this. I was born with.  and then be provided the tools to modulate and manage the expression of those genes can be very self-empowering. Mm-hmm. , 

certainly, I, I think it's probably one of the biggest things I hear most from chronic patients, myself included.

Um, years ago somebody told me that I needed to find joy in life that wasn't surrounded by just food. And I thought, well, that's one way to look at it. , um,  also, you know, we talked a little bit earlier about prescription drugs and, uh, I really like to talk about this a lot. I've been very honest about my journey.

Um, I take, uh, an antidepressant. It's been very helpful for me getting through a lot of the things that I've experienced over the past three years or even maybe even 10 years, um, that I just hadn't dealt with. And the, the drug has been helpful. Um, of course it's far more socially acceptable today to take them than maybe.

you know, 20, 30 years ago. But there's still a lot of patients who are hesitant, um, whether it's, you know, they, they feel lesser than or they don't want their friends and family to find out, or they're worried about all the other medications they're on and the side effects that may come from these drugs.

Of course, I'm very empathetic to that as somebody who had a severe reaction to a drug. Um, . I know that sometimes these fears are just fears and they're not always substantiated. What would you say to somebody who was hesitant or maybe a little scared to take an anti-anxiety or depression drug when they really need it?

You know, that's a great question and um, I would say that feeling anxious or feeling scared or feeling skeptical is perfectly understand. Um, because if you're not feeling well and your body isn't working the way you want it to or hope for, understandably, you're gonna worry about what this foreign substance is gonna do.

Mm-hmm.  in your body. And one of the things we find with pretty much every person with a chronic illness, they need really tiny doses of medicine to start with. Mm-hmm. , because they're exquisitely sensitive to medications. The other thing we find is, Speaking earlier about the GENOMIND test, the advantage of having those pharmacokinetic genes available to look at blood levels and know how rapidly or slowly different medicines are metabolizing, be able to input into the gene drug interaction database, all the meds, not just mm-hmm.

psychiatric meds. That helps. And then being able to look at the pharmacodynamic genes and say, well, . You know, for example, there's this gene SLC six A four. It's what's called the serotonin transporter protein gene. If you have, it's called a short allele. It's a deletion of, of, uh, uh, a deletion allele. If you have that allele in your personal genotype, you shouldn't be on an s sri mm-hmm.

You're gonna have potentially more anxiety or a panic attack or gut symptoms interesting than ssri.  trying to move away from the trial and error approach. Mm-hmm.  to a more precise approach is aided and enhanced by both the genetic testing as well as the knowledge of someone's chronically ill. They really, you need to start low, go slow.

Mm-hmm.  with those medicines, and then look at the gene drug interaction using that software. But I can say that. . In today's world, the science is just not there to treat a major depressive disorder or a panic disorder or a serious O C D disorder or other major psychiatric illnesses without prescription medicine.

We like to think ahead. What is science gonna look like five years from now, 10 years from now, 50 years from now? We really, and we love to brainstorm that internally in the practic.  will we eventually get to the point where we don't need these prescription medicines perhaps? Mm-hmm. , we're not there today.

And the reality is many of them modulate the immune system. Mm-hmm. , one of the antidepressants we use Trintellix. Mm-hmm.  has really, really significant immune system. Modulating effects some of the antipsychotics, like, uh, pone down, regulate immune system. Turn. Uh, genes that cause pro-inflammatory cytokines.

Oh, wow. And on genes that promote anti-inflammatory cytokines. Um, so these medicines don't just work on serotonin, NOP and efrein dopamine. They work on, you know, many of them work on immune modulation effects as well. Mm-hmm. . . 

I really love that approach. I often say to doctors when there's something new coming at me, please don't experiment too much because I feel like I lose so much of my life, either in a flare or most recently having a drug reaction or something.

Don't take even more of my life away. Let's try to get to the point . Well, 

and also, you know, the other thing we're sensitive to and, and Julie, um, is much more evolved and closer to this than I. . But when you have a gut that is sensitized already and you need that sort of nuanced approach, where well, at the beginning, you know, giving a diet that maybe has resistant starch or ferment fiber, maybe that's gonna cause problems.

Or we have a gut that's inflamed, maybe that's a later stage issue. These medicines.  be in completely, um, absorbed from the gut into the bloodstream, may potentially activate something in the gut. So that's where we work as a team approach, yes. Where we can monitor this. And again, looking at really exquisitely small doses to start whether the gene genetics, the, the, the way the enzymes and liver break.

the drugs are, are, uh, slow or not, we're still gonna go slow with someone who has a chronic condition because of these sensitizations in the gut. Mm-hmm.

So every show I ask my guest what they wish they knew when they were first diagnosed with their illness. Um, so what would you, as a psychiatrist and as a nutritionist, uh, what would you wanna tell somebody who's being newly diagnosed, uh, with a chronic illness? , 

I would say feel hopeful that, um, first of all, you're not alone.

Mm-hmm. , sadly, uh, the rates of autoimmune diseases arising mm-hmm. , the rates of mental illnesses arising, complex answers as to why, um, you know, there's a lot of good research coming out now about near infrared light. Mm-hmm.  getting out in the. , you know, getting out in the sunlight first thing in the day and trying to get 30 minutes of sunlight a day.

Mm-hmm.  at least. Or maybe if you can't, you know, adding near infr red light, getting out into nature, walking in nature. You know, we've gotten so far removed from, uh, the kind of ambient environment that our DNA n a evolved under for, you know, ultimately a few billion years now. We have the history of all life in our dna.

So I think there's a lot of great science emerging, feel hopeful about. The knowledge base is exploding. Incredible knowledge coming out. You know, in our field, what are the great frontiers? Genomics, the gut microbiome, the immune system, and the role of infectious diseases. So there's a convergence of all of that.

There's international cooperation around all that, their international symposia developing. Um, so feel hopeful that. , the knowledge is emerging to really help you. That's one thing I would say. I dunno, what, what do you think, Julie? You're the one. 

Yeah, I I would definitely start there because I think there is a lot to be hopeful about and our understanding of how to support patients with chronic diseases is, , even over the course of my career has just shifted so dramatically.

Um, and then I think the other thing I would add to that is that while these are complex, uh, circumstances, complex disease patterns, there are things that you can do personally. So you feel active in your own care. That I think really does. In situations like this where you feel a little bit out of control, right?

And feel like things are happening to you. And I think, um, focusing in on ways that you can maintain that personal power through the process is, is really uplifting to the spirit. And, you know, we know.  actually. It's not just a, a feeling that you're having, it's, it's a biochemical reaction that allows that feeling to happen.

And that in and of itself is a part of the healing that we want to encourage. And so, um, Looking at everything from, you know, what you're choosing to eat or who you're choosing to interact with, how you spend your time. Um, try to maintain some locus of control around pieces of your world, um, that you can build out from.

And, um, that to me personally when I went through sort of a health hiccup, It's scary, you know? And, and so grounding myself in things that, um, really felt nourishing was really helpful. That's 

really great advice. One day I'm hoping to put something together, you know, even if it's just a great checklist that somebody can go down and look at, just say, okay, it's gonna be all right.

I have the info. So. 

Well, it's interesting. Um, I'm sorry, just to interrupt my apologi. . Um, but you know, that checklist, I really like that approach. Mm-hmm. , it's, it's really, uh, how we operate. Mm-hmm. , we, we build a database, so it's got lots of checkpoints mm-hmm.  database of, uh, each individual's unique findings that we find in them based upon the genetic testing, laboratory testing.

So it is kind of like a checklist and then mm-hmm.  every week we meet, um, and go through the checklist and we see how we're. , you know, and, uh, we, we, we address each of the checkpoints, as it were. Mm-hmm. . 

It's really helpful when you can just take that moment and take stock of what's happening, do your checklist, make sure you're, you know, you just know what's ahead.

Um, or even if you don't know exactly what's ahead, you know, what others have gone through and you can at least prepare. Mm. So before we go, would you be able to tell our listeners more about Potomac Psychiatry Specialty Programs and how they can learn more about them? 

Sure. Um, we have several different specialty programs.

We covered root cause, psychiatry, mm-hmm.  earlier. We also have a program Recode Pre-Code. Those are acronyms that stand for reverse cognitive decline and prevent cognitive decline. They're based on the pioneering work of Dr. Dale Bredesen and, uh, Julie was one of the pioneers who trained under Dr. Bredesen, along with, uh, Dr.

Paolo Negro in our practice, who's an MD PhD psychiatrist. Um, we have, um, a specialized program, uh, for, uh, autism spectrum disorders where, um, we have a, uh, very prominent developmental behavioral pediatrician who, um, Has, uh, had leadership positions in that field who worked with the really young children aged 18 months to five years.

We have child, uh, an adolescent psychiatrist who specialize with the elementary school, middle school, high school, and college age, um, patients with autism. Um, there's some really remarkable, um, findings emerging in that field. There's a. Called the FRACT test. The folate receptor antibody test, which actually it's the first autoimmune test, uh, identifying, uh, auto antibodies to brain tissue in patients with autism.

Estimated it probably close to 75% of patients have it, and if they do have it, there's a very simple intervention with um, uh, a high dose vitamin called leuko. , they can treat it. There's emerging data around the use of sulforaphane in, um, patients with autism. And these are potential game changers, not cures.

I'm not right promise. But there's, um, a neurodevelopmental panel that Inxs d n a has developed with, uh, uh, looking at genes, uh, in children, adolescents and young adults, uh, and adults with. , these developmental disabilities, including autism. So that's a specialty program. We also have a, uh, forensic psychiatry program, uh, with expert witnesses, and then Julie runs a nutritional psychiatry program.

So for those who are really adamant about, well, I'm not taking a prescription mm-hmm.  medication mm-hmm. , then you know, Julie will work them up and see. , you know, if it's more mild to moderate symptoms, whether a a purely nutritionally based approach will work. I don't think I'm leaving anything out. Uh, I think that covers it.

That's pretty amazing. I, I, I could probably listen to you all day long talk about what you've learned about autism. That was really fascinating. And of course, I think anybody with an autoimmune condition knows, especially if we've had it for a while. , okay, something can't be cured. But if I can live a better life than I did before, it really is a game changer.

It, it really is. There's a big difference between me, you know, too weak and unable to get out of bed and when I can actually do my running and triathlons and the things that bring me a lot of joy. So I, I just think that's amazing. Uh, thank you so much for speaking with me today. This has been an just a great interview.

I, I really appreciate the time you've taken out of your day, uh, to come here. So, um, again, thank you Dr. Bruce Kehr and Julie Wendt of Potomac Psychiatry. Thank you for speaking with Living Chronic.