#406 – Listening to Your Gut with James Greenblatt MD

James Greenblatt

James M. Greenblatt, MD, a pioneer in the field of integrative medicine, has treated patients with mood disorders and complex eating disorders since 1990. After receiving his medical degree and completing his psychiatry residency at George Washington University, Dr. Greenblatt went on to complete a fellowship in child and adolescent psychiatry at Johns Hopkins Medical School. An acknowledged integrative medicine expert, Dr. Greenblatt has lectured throughout the United States on the scientific evidence for nutritional interventions in psychiatry and mental illness.

His books, Answers to Anorexia and The Breakthrough Depression Solution, draw on his many years of experience and expertise in integrative medicine while treating patients with eating and mood disorders. Dr. Greenblatt’s knowledge in the areas of biology, genetics, psychology, and nutrition as they interact in the treatment of mental illness has led to numerous interviews by the media on television as well as in written articles for consumer audiences.

Dr. Greenblatt currently serves as the Chief Medical Officer at Walden Behavioral Care in Waltham, MA and serves as an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine. He is also the Founder and Medical Director of Comprehensive Psychiatric Resources, a private psychiatric practice focused on utilizing integrative medicine.

His third book, Answers to Appetite Control, will be published at the end of April 2014.

Click here for the article we discuss in this interview!

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copyright 2014: David Van Nuys, Ph.D.



  1. Posted June 5, 2014 at 5:57 pm | Permalink

    Very interesting interview Dr. Dave. It made me reconsider something that occurred for me almost 35 years ago now.

    When I was around 30, I entered therapy as a last resort at dealing with the panic attacks that had plagued me since I was 13 and had brought me to the brink of seriously considering suicide. I had also been borderline anorexia for as long as I could remember, which I never considered abnormal because my mother was the same and anorexia wasn’t the well known disorder that it is these days. I resolved the panic attacks through the therapy and as a side effect I got over my eating disorder but I retained the tendency to lose my appetite in times of stress.

    When I was 52 and had a major meltdown over a series of life crises, this habit kicked in and in addition I was feeling constantly nauseous. I eventually went to an acupuncturist, who was a medical doctor practicing alternative medicine, for another debilitating physical problem unrelated to anything to do with the digestive system. He asked if he could do a hair analysis test on me and when it was done, informed me I had a severe candida infection. I had never heard of such a thing. I hadn’t told him about the lack of appetite and nausea. He recommended a diet and probiotics. The diet was extremely severe, being like a combination of a coeliac diet together with a diabetic diet and being already in a situation where I had little appetite, to have my food choices further restricted felt like a severe punishment but I decided to give it a go.

    I was told it would take about 3 months for things to stabilise and that I would need to stay on the diet for at least 9 months to give my system the best chance of building up a good immunity to a reoccurrence. At almost exactly the six weeks mark, it felt like a miracle had occurred. My appetite came back in full force and the nausea abated but because of the restrictive food choices, I now had the additional problem of not being able to eat what I wanted for another seven or eight months! I also felt much better physically in myself, which had a flow on effect on my mental and emotional outlook. I had never considered the possibility that it was having a physical effect on my attitude, I had put it all down to the psychological effects.

    I did stick to the diet to the bitter end and have never had a reoccurance of the candida. I eat pretty much anything I like but I did keep up the probiotics and feel they have a very beneficial effect on my digestive system health. To learn that they are probably also having a beneficial effect on my mental health is an added incentive to keep them up because they are not cheap and I do have some ambivalence about whether or not the benefits I feel is a placebo effect.

    Coincidentally, not long after I started the diet, I subjected myself to a free iridology exam that was being offered at a chemist I happened to be passing and without giving the iridologist any information, she told me that there were severe disturbances in the small intestine. I then told her about the candida diagnosis and treatment and she wasn’t at all surprised.

    “Food for thought?”

  2. Oskar
    Posted June 7, 2014 at 3:30 am | Permalink

    Hi David,

    This last interview was no doubt the best on the nutrition—gut—mind series so far. While some of the previous interviewees seemed to lack some solid grounding in the field, this guy really knew what he was talking about.

    I don’t know if you remember it, but a year or two ago I wrote to you about the gut—behavior connection and its possible implications on psychiatry.

    I also recommended you to contact two of the world’s foremost superstars in the field: Dr. Natasha Campbell-McBride, founder of the GAPS diet; and Chris Kresser, integrative medical practitioner who always seems to be in the forefront of gut health. I think these two—especially Kresser, since he doesn’t have a vested interest in any product or specific diet—would provide even more depth to the subject.

    Your listeners should finally know that if they do have SIBO, the kind of bacterial overgrowth your guest mentioned, most probiotics are contraindicated, according to many practitioners. There is a rationale for this—in a nutshell, the idea is that you have to starve the overgrowth of bad bacteria in the small intestine (the SI is actually quite void of bacteria in a healthy individual) before providing new, beneficial ones, which you want to colonize the colon.

    Just wanted to mention it so SIBO affected listeners don’t start some megadose probiotic, which may make them feel ill.

    In fact, most people with a real condition will feel ill when starting probiotics; it’s a sign they’re working, and so one needs to titrate them carefully.

  3. Posted June 9, 2014 at 8:20 am | Permalink

    Great interview! I’ve been following Dr. Greenblatt’s work throughout the year, as I am a mental health counselor working at an integrated college wellness center. I believe strongly in taking an integrated approach to treatment. I hope to incorporate this podcast into my syllabus for the Foundations of Mental Health Counseling this upcoming fall semester.

  4. Dr. Michael Ocana
    Posted June 15, 2014 at 5:58 am | Permalink

    I’m pretty sure fiddling with gut flora will get us little farther than fiddling with neurotransmitters has.

    The causes of mental illness and much of medical illness actually lie are in our stress responses. If we can identify the factors that drive stress and empower one another to overcome them we are on the right track…

    When we fiddle with symptoms of stress… we are not usually going to get the results we want.

    I’m disappointed that “integrative” psychiatry in this iteration does not seem to “integrate” the psychosocial in any way.

  5. ShrinkyDink
    Posted July 4, 2014 at 5:56 pm | Permalink

    Interesting interview with James Greenblatt. But the questions that Dr. Dave asked about specific probiotics were answered in general terms. Like Dr. Dave, I was curious about use of probiotics for mental health, and so went searching for what the different types were used for. Pure Encapsulations, the company recommended by Greenblatt, doesn’t give a lot of specific information about prescriptions, aside from the name of one of them: ProbioMood. It looks like Pure Encapsulations is also working on the release of 3 other formulas, including Serotonin and Dopamine support. But looking around at some reviews, there is caution for use of the serotonin support for folks with Bipolar disorder for the obvious mania kickstart. I’d like to know more about what is in the Probiomood formula as well as if a different probiotic would work for Bipolar disorder.

  6. John Knight
    Posted July 9, 2014 at 9:41 pm | Permalink

    I should restate a precaution we were taught in our critical thinking component of psychology and science: when looking for evidence on a claim, anecdotal evidence is scientifically inadmissable.

    Of course stories and cases around interesting or promising results around something new are excellent grounds for new research projects, but we simply don’t know the whole story and don’t have any of the controlled variables required for scientifically admissable evidence.

    Anecdotal evidence is generally the first kind of evidence used by “snake-oil merchants” (as our family has discovered the hard way, losing thousands of dollars on sophisticated placebos), and although anecdotes make for interesting reading, I find most areas of solid research usually avoid using them. (I find it helpful to raise a small caution flag the minute someone reaches for anecdotal stories of getting better on something; it doesn’t mean it’s false, but it’s something good researchers try to avoid).

  7. gail
    Posted September 30, 2014 at 4:50 pm | Permalink

    He stated he first noted his connection between the gut and the brain came about w/ his work w/ autistic children.
    He ought to have stated research has been done connecting the same thing with MANY who have had the MMR vaccine.

  8. Jimmy Pryor
    Posted August 11, 2015 at 9:32 pm | Permalink

    I enjoyed this interview with Dr. Greenblatt.

    I have been hearing much about the microbiome over the last several years through Science magazine, This Week in Microbiology and other articles published in scientific journals.

    The fecal “implant” referred to is more commonly called a “fecal transplant”. It has received a great deal of attention for the treatment of clostridium dificile, an unwanted intestinal bacteria that has become epidemic, mainly contractred during hospital stays. Some physicians are not recommending this as a first line of defense in treatment.

    I have read a number of articles connecting mental conditions and mood with the gut flora. Some reports link the consumption of yogurt with improved mood. Personally, I noticed improved mood when I began cultivating kefir, milk that has been fermented with a community of bacteria and yeast. Anecdotal, to be sure, and perhaps a placebo effect.

    Kefir is prescribed for irritable bowel syndrome and (anecdotally) a coworker found it helpful with her son’s ibs.

    One concern with the interview in question: I noticed upon investigation that the address for Dr. Greenblatt and for Pure Encapsulations, the brand he recommends, are one in the same! I believe that this should have been disclosed. Given the apparent connection, Dr. Greenblatt’s recommendation is less credible.

    All-in-all I do feel informed by the interview and thank you for having him on.

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