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Dr. Deb Muth 00:03
Welcome to Let’s Talk Wellness Now. I am your host, Dr. Deb.
And today, I have the pleasure of meeting with Dr. James Greenblatt. I’ve known Dr. Greenblatt for a very long time. We, started lecturing together, gosh, over 15 years ago.
And he is an amazing practitioner. Dr. Greenblatt is dual board certified in psychiatry and internationally recognized.
as a pioneer in functional and integrative psychiatry. He’s widely regarded as the leading expert on the clinical application of low-dose lithium for mental health.
Dr. Greenblatt has spent more than 30 years advancing precision medicine-based approaches that move beyond symptom management to address the root causes of mental illness.
And after earning his medical degree at George Washington University.
Dr. Greenblatt completed his psychiatry and residency there as a fellow in child and adolescent psychiatry.
Joined John Hopkins Medical School, and he currently serves as an assistant clinical professor of Psychiatry at Tufts University. He is a prolific author. Dr. Greenblatt has written 9 books, including his newest book, Finally Hopeful. in… available in January of 2026. We can ask him about this today.
And his bestsellers finally focused the breathwork, natural treatment plan for ADHD,
Answers to anorexia, Functional and Integrative Medicine for Antidepressant withdrawal, and nutritional lithium, and Untold tale of Mineral and Transforms Lives, that heals the brain.
He has founded, in 2019, the Psychiatry Redefined, a leading educational platform training clinicians worldwide in functional and integrative psychiatry. He is a sought-after international speaker. Dr. Greenblatt regularly lectures
On nutritional psychiatry and the transformative role of functional medicine.
I am super excited to have him here with us today. This is going to be a pleasure. You guys are going to love this conversation that we are going to have.
And I am going to pick his brain today on functional and integrative psychology and psychiatry, and combining nutrition, biochemistry, and lifestyle with mental health care.
I’m really, really happy to have Dr. Greenblatt with us, so I am going to bring him on, and we are going to have this amazing conversation with my friend.
Welcome back to Let’s Talk Wellness Now. I’m your host, Dr. Deb, and I have with me Dr. James Greenblatt, who I have followed for… we were just chatting about this for over 20 years.
He is amazing in what he is doing, and we are going to have this conversation today about integrative psychiatry and the future of mental health. So, welcome to the show, Dr. Greenblatt.
James greenblatt md 03:20
Thank you, Dips, good to be with you.
Dr. Deb Muth 03:22
Now, you’ve been pioneering this integrative psychiatry for decades. What really inspired you to bridge nutrition and psychiatry long before it’s become mainstream?
James greenblatt md 03:35
You know, I developed an interest in college, you know, studying nutrition, and then I remember writing papers on orthomolecular psychiatry, high dose, vitamin B3 for schizophrenia.
So, I really did not think I’d be a psychiatrist. I wanted to be a pediatrician when I went to medical school, but, just early interest in nutrition and brain function.
And it’s been my career now for 30-plus years.
Dr. Deb Muth 04:05
Wow. Can you define what integrative psychiatry actually means, and how it’s different from traditional psychiatry for most people who wouldn’t be familiar with that term?
James greenblatt md 04:17
Sure, I mean, I have to add the word functional as well. I mean, I think, you know, I call myself a functional psychiatrist, but for most of my career, and every book, and everything I did, I would have to use words like functional and integrative.
Medicine for mental illness. And, you know, I define integrative medicine as the… Adjunctive lifestyle, mindfulness. And diet, sleep, and exercise.
Dr. Deb Muth 04:46
Mmm.
James greenblatt md 04:46
And I kind of use the term functional for kind of a deeper root cause dive, looking at nutritional deficiencies, looking at hormones, looking at genetics. And, you know, to treat patients with mental health challenges, we need both integrative and functional medicine.
Dr. Deb Muth 05:05
That’s awesome. You know, in our integrative space, we often kind of joke that there’s no such thing as a Prozac deficiency, right? Can you explain to our listeners how nutrient deficiencies, gut health, or inflammation can play a role in mental illness?
James greenblatt md 05:23
Sure, I mean, I think the most important
Beginning of this conversation would be that, you know, 10 people with depression, there might be 10 different underlying factors.
Dr. Deb Muth 05:35
Yeah.
James greenblatt md 05:35
And we do know that there’s not an antidepressant deficiency, so we have to look deeper. And… and that’s,
just different than our current psychiatry model, where it’s just symptomatic-based medicine. Everyone who’s depressed. It’s an antidepressant.
And by looking at functional integrative medicine, we’re looking at B12 and vitamin D and zinc and magnesium. We’re looking at hormones, we’re looking at the gut, and we’re trying to determine what might be either causing or contributing to that person’s depression.
Dr. Deb Muth 06:10
Is there a particular, flavor that you see more commonly with others, like depression versus anxiety versus bipolar. Is there a particular underlying factor that you see more commonly than others?
James greenblatt md 06:27
Well, the short answer is no, and that’s why this work takes time, because you have to think.
You know, every patient that walks in the office is different. I mean, I think the overarching umbrella is nutritional deficiencies, you know, whether… regardless of weight, regardless of diet. I mean, I have people coming in who’ve been eating…
You know, these ketogenic or paleo diets, you know, perfect organic foods, and are profoundly nutritionally deficient.
So I think nutritional deficiencies would be number one, and then, you know, the whole host of, you know, infections and hormone problems and inflammatory issues related to celiac disease is really common in the mental health space that’s ignored.
Dr. Deb Muth 07:14
Yeah. Celiac disease is really not paid attention too much, other than thinking that it’s damaging the gut. They don’t really think about all the other aspects of the body that are being affected by the gut not being able to absorb the nutrients properly and then utilize them properly. It’s really sad.
James greenblatt md 07:34
we find out… and there’s research to support it. That’s the tragedy. This is not something, as clinicians, that we found. We have many, many years of research showing high rates of anxiety and depression, you know, amongst those with, celiac disorder because of this chronic malnutrition, and many patients present without any GI symptoms, just mental health complaints, but nobody’s looking at celiac.
Dr. Deb Muth 08:02
Yeah. You know, I’m sure there’s people that are listening to us thinking, there’s no way that
Everybody who’s depressed or anxious has a nutritional deficiency. When we’re… live in a country where there’s so much abundance of food, and the obesity rates are high, and most people are very plump, how could those people be deficient in nutrients? What do you say to people who think like that?
James greenblatt md 08:28
Yeah, I mean, I think that, you know, we have, what’s called high caloric malnutrition, so regardless of weight, I would say the vast majority of patients with a mental health issue I would say my best guess would be 90-plus percent.
Dr. Deb Muth 08:47
Wow.
James greenblatt md 08:47
We would find nutritional deficiencies.
Dr. Deb Muth 08:51
And part of this, we’ve discovered, is genetics.
James greenblatt md 08:56
People having, kind of, genetic needs for Higher amounts of certain micronutrients. Some of it is just the kinds of foods people are eating. The kind of ultra-processed food actually strips the body of micronutrients. So, it is just so common, and many of these tests are pretty simple that your primary care doctor could do in the office.
Dr. Deb Muth 09:22
So, traditional labs can identify some of these nutritional deficiencies. They don’t necessarily have to invest thousands of dollars in advanced nutrient testing to find these things out.
James greenblatt md 09:35
Absolutely. I mean, I think, you know, oftentimes when we’re working with a patient who has failed traditional psychiatric treatment, we do need some functional, testing, but I’m quite convinced we could change the trajectory of our mental health epidemic in this country by some labs that are covered by every insurance company on the planet. Like, people think of vitamin D as, you know, building bones or immune function.
It has dramatic relationships to mental health problems, demonstrated over 30 years of research. So vitamin D and B12 and folate, all simple blood tests that are covered by all health insurances.
Dr. Deb Muth 10:18
You know, with the change of genetics, MTHFR is so popularly known these days. It’s probably the most popular genetic mutation that people know of.
And in the mental health space, it plays a significant role as well in that absorption of B12 and folate. How do you look at MTHFR mutation with inside the mental health world?
James greenblatt md 10:43
Well, I think it’s, It’s critical, it’s required on every patient that I see, and I’ve been, known to say it would be considered malpractice for psychiatrists not to test for the MTHFR gene. Because most of my career, I’ve spent working in inpatient psychiatric hospitals and residential. So seeing those individuals that have failed outpatient treatment, so really struggling.
And one of the most common things I’ve been seeing for 30 years are those psychiatric patients not responsive to traditional treatment. oftentimes have one of the more significant MTHFR variants. And so we started doing the testing in the hospital, and they came back with these you know, variants and treated with folate, the medicines worked better, and their depression got better. It is simple. And essential. So, the integrative community, our community is aware of it, but our conventional psychiatrists are not testing for MTHFR.
Dr. Deb Muth 11:50
Yeah, it’s so sad, isn’t it? Because it’s such a simple test, and can make such a big difference in people’s lives. I know even in the OBGYN community, we’re not looking at MTHFR, and yet we’re giving women all this folic acid that many of them might not be able to actually utilize.
And we’re… in my opinion, we’re doing a disservice to those women and the children that are being born to them for that.
James greenblatt md 12:15
Yeah, no, it’s frustrating, when there are clear, simple, treatment interventions that could make major difference in people’s lives that are just not incorporated into, kind of, routine treatment models.
Dr. Deb Muth 12:31
How come we see some people with MTHFR mutations, or gene mutations, have depression and anxiety that is so severe, and then other people seem to have absolutely no problems with mental health at all, and they have a similar profile?
James greenblatt md 12:47
Yeah, I mean, that’s just a great example, as, you know, genes aren’t our destiny, it’s just kind of a vulnerability.
And, you know, we actually, when we were in the hospital, we tested, you know. hundreds of people and staff as well. And, you know, people are going to be lived to 100 and have these very vulnerable MTHFR genes. So it’s not the genes, it’s… I call it that genetic-environmental dance. So if we add… that genetic vulnerability, and maybe we add a, you know, a Lyme infection, or a chronic stress, or a B12 deficiency, or celiac, or we could list a hundred things, stress and inflammation probably being the most significant. With that genetic vulnerability, that’s where, you know, the implications of treatment come more defined.
Dr. Deb Muth 13:45
Yeah. What do you think the role of trauma plays in all of this, too, with the genetics? Do you think that trauma that people are living with today makes a big impact on their genes and how their genes are being turned on or off?
James greenblatt md 14:01
Yeah, I mean, we know trauma is kind of, you know, sets the stage for so much psychiatric illness. I think in my… Community of mental health professionals. we kind of use the trauma as an excuse to not think of the biology. And trauma… Affects the biology.
Dr. Deb Muth 14:21
So…
James greenblatt md 14:22
without negating the past trauma or current trauma, we still need to dig deep into the B12 and MTHFR and vitamin D. But… the trauma does affect the expression of certain genes. It also ex… we see a lot of, nutritional deficiencies after trauma due to poor digestion, because the Digestive enzymes and the hydrochloric acid kind of just shut down. And so, again, eating great food, but not absorbing these micronutrients. So I’ve seen that years after trauma.
Dr. Deb Muth 14:5
Yeah, it’s really hard. I’ve worked with Dr. Mark Gordon, and he does a lot of trauma work for veterans, and he focuses a lot on the hormones that get affected because of the brain trauma and the head trauma that people experience in combat. Or the repetitive shot firings and things like that, and how it correlates to anxiety. And then just balancing out some of those hormones can make a significant difference for them, and he’s actually been tracking the reduction of some of the hormones as a result of those traumas. Have you seen similar things like that with mental health and hormones?
James greenblatt md 15:36
Not… I haven’t made that direct correlation, but what we see when we evaluate somebody with trauma is just, you know, a kind of very wide range of metabolic abnormalities from Hormonal, to insulin resistance, to nutrient deficiencies, again, that aren’t dietary related.
Dr. Deb Muth 15:57
So…
James greenblatt md 15:58
Definitely, somehow, some path from the trauma.
Dr. Deb Muth 16:03
Yeah. If you had to choose your most favorite cutting-edge research or biomarker that you’re most excited about right now in the world of nutritional psychology or psychiatry, what would that be?
James greenblatt md 16:19
Well, you know, I counted as 250 that we look at when I evaluate a site patient, but there’s one… That is so simple, and has such profound implications, and that’s looking at levels of cryptopyrrol in the urine.
Dr. Deb Muth 16:36
Oh, yeah.
James greenblatt md 16:37
urine test. It measures this, molecule, a pyrole derivative, and Most of us would have normal levels. And if it’s elevated, It is, it’s likely a genetic vulnerability, but this, cryptopyrrol just binds B6 and zinc. So you have this tremendous deficiency of B6 and zinc. And elevated cryptopyril is always associated with psychiatric symptoms, usually anxiety, but we’ve seen depression and panic and even paranoia. And it’s simple to treat. We’re talking about, you know, pennies a day, B6 and zinc.
Dr. Deb Muth 17:20
The marker comes down.
James greenblatt md 17:23
And symptoms improve. I mean, it is really stunning and dramatic.
Dr. Deb Muth 17:28
That is amazing, because you’re right, I mean, in something that seems so simple and so inexpensive oftentimes gets dismissed, because we think that it’s not going to do enough, but some of these things that biochemically are happening to people Really need to start being addressed, because the side effects that they’re having with multiple layers of medications is not good for them either.
James greenblatt md 17:52
Yeah, the amount of medications now, because of our kind of ineffective model, is just exploding, so people are taking 3, 4, 5 psychiatric medications to treat a problem that sometimes there might be a simpler solution.
Dr. Deb Muth 18:11
Yeah. Can you share a case example of where an integrative approach really transforms someone’s mental health when medication alone wasn’t working?
James greenblatt md 18:22
Sure, you know, many, but there’s one that I just talked about, A couple nights ago about a gentleman who, you know, traveled around the country seeing integrative doctors, as well as traditional doctors, had a bag full of supplements, because every Doctor put them on a different regimen. And, strong family history of depression and addiction. He struggled with depression and addiction. And, you know, could not get off antidepressants. So, he had a lot of blood work, everything was normal, and the one test that we found in our battery was low levels of essential amino acids.
Dr. Deb Muth 19:08
Wow.
James greenblatt md 19:09
So this was, someone who was eating, you know, organic foods and grass-fed protein, so he was eating the perfect diet.
But he was completely deficient in amino acids. So, again, that inability to digest and absorb, so just by giving this individual hydrochloric acid. Free-form amino acids. He was able to begin to feel better, and eventually we were able to taper him off these medications. So it was just, it wasn’t dietary intake, it was a problem of digestion and absorption.
Dr. Deb Muth 19:50
That is incredible, because I don’t think, even in the functional medicine world, where we’re focused so heavily on gut health, we are not making that correlation that people are not digesting their proteins to make amino acids, to make neurotransmitters. That… that thought process isn’t happening with a lot of functional medicine practitioners either.
James greenblatt md 20:11
No, it hasn’t, and maybe because it’s too simple, you know? It’s not trying to look at 75 markers on organic acid, it’s just…
Dr. Deb Muth 20:21
Yeah.
James greenblatt md 20:21
Looking at, you know, 9 essential amino acids. And usually there’s a pattern. They’re either all low, you know, or normal, or high, and that means something. So, I remember when I first did amino acid testing, it was by mistake. I remember in the 90s, I checked the wrong box in a lab company. And it didn’t make sense to me when I first started doing it, but now it is one of the most important tests that I do for adult depression.
Dr. Deb Muth 20:49
Yeah. How do those amino acids, work with, like, that resistant depression, anxiety. What do they actually do that makes the anxiety and the depression worse?
James greenblatt md 21:02
Well, the essential amino acids, essential meaning our body needs to get them from our diet, are the precursors to every protein in the body, but in psychiatry, they’re the precursors to the neurotransmitters.
So, tryptophan, precursor to serotonin, phenylalanine, the precursor to dopamine and norepinephrine. So if those are deficient.
And we have studies in humans and animals, going back, I think, to the 70s, that we can affect the levels of neurotransmitters in the brain. So low levels of these amino acids affect neurotransmitters. It’s actually a research protocol called tryptophan depletion studies. Where we give people in the lab low levels of tryptophan, and we watch them get irritable, depressed, and angry.
Dr. Deb Muth 21:51
It’s interesting that we’re willing to do that to people, right? But you’ve got to figure it out sometimes. You have to know that what you think is actually working.
James greenblatt md 21:58
Absolutely.
Dr. Deb Muth 22:00
Yeah. How do you guide patients to safely combine their natural approaches with their psychiatric medications?
James greenblatt md 22:09
I think the vast majority of the, the work that we’ve been doing, is all nutritional supplements or interventions that can be done with medications. So it’s not an either-or model when we think of functional psychiatry. It’s just kind of adding tools you know, to the toolbox. There are very few interactions with medications. Sometimes high-dose amino acids we won’t use with certain medications, but all the Vitamins and minerals and gut support that we’re recommending can be utilized with medications.
Dr. Deb Muth 22:49
That’s awesome, because I think there’s a lot of fear around that, right? Like, if I take this, it’ll interfere with that. And some things, yes, they do interfere, but it’s good for people to understand that they can do these things safely, but they need to work with somebody knowledgeable, like yourself, or somebody that has come from one of your training programs that really, truly understands this.
James greenblatt md 23:10
Yeah, absolutely. It’s, it’s an integrative model where individuals can Sometimes it’s just the medications work better. Other times, it’s a path to tapering someone off the medications.
Dr. Deb Muth 23:24
Yeah. For patients or families that are listening, and they’re really feeling frustrated by medication-only solutions, where do you recommend that they start?
James greenblatt md 23:36
Well, I have to say my book. So, you know, the book I just wrote, Finally, Hopeful, is written for patients, and I think the title is the best part of it, you know, Hope. I think as you begin to appreciate the role of nutrition and depression. So, there are some, some good books out there, that, on my website, psychiatryRedefine.org, there’s a list of clinicians, and, in the next month, I’ll be setting up a network of functional psychiatry clinicians, So, around the country that have been trained, so that program is called Finally Living Now, I think, Finally Living Now, so…
People, want the information. Too many of our traditional docs just don’t have the training, so we’ll hopefully be able to provide a network of clinicians who can help.
Dr. Deb Muth 24:30
That’s fantastic, and for those of you who are driving or didn’t catch those links, don’t worry about it. We will have them in the show notes for you, so you can find these people that have been trained and understand what to do to help you. What gives you optimism about the future of psychiatric and mental health care?
James greenblatt md 24:51
Well, the explosion of research is really, have given me some renewed energy at this point in my career, because in the last 5 years. There are just hundreds of incredibly well-written academic articles, references that our traditional researchers have kind of just validated everything that we’ve been saying for 30 years. So we have studies on vitamin D deficiency, and suicide, and zinc deficiency, and suicide, and folate, and the gut. And the most significant for me is, I’ve been talking about lithium orotate.
Dr. Deb Muth 25:34
Print this.
James greenblatt md 25:34
years as a nutritional intervention, probably the most important in my practice, and a study came out of Harvard. This year, Describing lithium orotate, the only lithium preparation that was able to reverse Alzheimer’s pathology in mice models. and prevent it in these models. It was a pretty dramatic study.
Dr. Deb Muth 25:57
Oh.
James greenblatt md 25:58
So… Long-inded answer, but it’s the research now that is just supporting everything we’ve been yelling about for 30 years that just is going to make it much easier to train doctors and nurse practitioners so we can help more patients.
Dr. Deb Muth 26:15
Oh, that’s fantastic. That’s an… I’m going to look up that study, that’s amazing. So, one last question for you is, if someone was listening today, and they’re really struggling with anxiety and depression, and they’re out of answers, what would you tell them to give them hope?
James greenblatt md 26:32
I think that, you know, I’ve been doing this 30 years, and I have colleagues around the globe, and Everyone would kind of just echo that there are some simple interventions, and to try to find either your primary care doctor, or a mental health professional, or a naturopath who will dig deeper and look at some objective tests, and I’m positive that if you’re struggling with depression, that they’ll find something to help you.
Dr. Deb Muth 27:06
That’s awesome. Thank you so much for joining us today. Are there any last thoughts that you want to leave with our listeners?
James greenblatt md 27:13
Well, just to repeat two things I’ve said a couple times is, hope, you know, finally hopeful is the book, and then everyone’s different. And your neighbor might be taking, you know, found out that they had a vitamin B12 deficiency, and that cured their depression. it doesn’t mean you have a B12 deficiency, but there are many. a path towards looking deeper. Everyone’s different, but there is hope.
Dr. Deb Muth 27:44
Thank you so much for joining me today.
James greenblatt md 27:46
Thanks for having me, nice talking with you.
Dr. Deb Muth 27:52
Thank you for joining me today on Let’s Talk Wellness Now and Dr. James Greenblatt for the insightful conversation on integrative psychiatry and the future of mental health.
If you’ve ever felt dismissed, over-medicated, or frustrated by cookie-cutter approaches to mental health, remember, there is always hope. Healing begins when we look deeper at nutrition, environment, biochemistry, and the unique story within every patient. That’s the art and the science Dr. Greenblatt calls us back to. If today’s episode resonated with you.
Share it with someone who needs to hear that mental health illness is not a life sentence. It’s a message from the body, asking to be completely understood. Remember, wellness isn’t just about feeling good, it’s about thriving in every area of your life. If you’re ready to explore how root cause psychiatry or functional medicine can help you or a loved one find hope again, visit DrGreenblatt.com and check out his new book that is just out. Until next time, I’m Dr. Deb, reminding you to take care of your body, mind, and spirit. Be well, and I will see you in our next episode.