Tag Archives: psychiatry

Dr. M’s SPA Newsletter Volume 16 Issue 12 – Creatine and Microbiomes


Creatine and Microbiomes

A new 2026 Cell Metabolism study explores a compelling and increasingly central idea in modern biology: the gut/brain/immune/metabolism axis is not just associative, it is mechanistic. Specifically, Dr. Lu and colleagues investigate how the gut microbiota can directly influence depressive behavior by reshaping systemic and neural metabolism. This is another in a long running list of papers describing the amazing work that bacterial commensal microbes do for us. In this case, our minds and moods.

“Although peripheral-brain crosstalk regulates energy metabolism, its role in depression remains unclear. Here, we used metabolic profiling to reveal elevated fecal creatine alongside reduced plasma and cerebrospinal fluid creatine in both patients with depression and mouse depression models. Exogenous creatine produced antidepressant-like effects mediated by gut microbiota. Bifidobacterium pseudolongum was identified as a significantly reduced gut bacterial species in depression, correlating with impaired creatine absorption. Subsequent supplementation with Bifidobacterium enhanced the antidepressant effects of creatine. Mechanistically, B. pseudolongum-derived acetate promoted the creatine transporter (Slc6a8) expression in intestinal epithelial cells via histone acetylation. The Slc6a8 mediated the antidepressant-like effects of creatine. Neuronal creatine deficiency influenced energetic metabolism and neurophysiological function. In patients with depression taking antidepressants, co-administration of creatine and Bifidobacterium increased plasma creatine levels and reduced depression scores. These findings identify the Bifidobacterium-creatine combination as a promising antidepressant strategy and highlight the critical role of gut-brain energy metabolism in depression.” “The brain, as an energy-intensive organ, relies on precise metabolic regulation to maintain synaptic plasticity, neurotransmitter synthesis, and stress response systems. Accumulating evidence implicates energy metabolism dysregulation as a hallmark of depression. Neuroimaging studies using positron emission tomography (PET) have identified marked glucose hypometabolism in the medial prefrontal cortex (mPFC) of patients with depression. Cerebral mitochondrial dysfunction and ATP imbalance have been mechanistically linked to depression progression. Notably, emerging studies emphasize the bidirectional interplay between peripheral metabolic signals and central energy regulation, which is fundamental to neural metabolism. Clinical observations such as fatigue, appetite dysregulation, and unexplained weight fluctuations in patients with depression further suggest systemic metabolic disturbances spanning peripheral organs and the CNS..” (Lu et. al. 2026)

This is next-level medicine. Mental health can no longer be framed as a disorder of genetics, experience, or circumstance alone. This work opens a clearer window, showing how the microbiome participates as an active partner, shaping brain function through the metabolites it helps produce and deliver. Compounds like creatine are no longer just peripheral players. They become signals, fuel, structure, and information, bridging gut and brain, metabolism and behavior…. and more

Enjoy,
Dr. M

Dr. M’s Women and Children First Podcast #69 Repost – Stephen Porges, Ph.D. – Polyvagal Theory


This week I sit down with Dr. Stephen Porges, a Distinguished University Scientist at Indiana University where he is the founding director of the Traumatic Stress Research Consortium. He is Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland.

He served as president of the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 400 peer-reviewed papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders.

He is the author of multiple books on his Polyvagal Theory: including the Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation, as well as Polyvagal Safety: Attachment, Communication, Self-Regulation. His newest book cowritten with his son is called Our Polyvagal World, How Safety and Trauma Change Us. Dr. Porges is the creator of a music-based intervention, the Safe and Sound Protocol ™ (SSP), which is used by therapists to improve social engagement, language processing, and state regulation, as well as to reduce hearing sensitivities.

This is such a fascinating conversation. He brings the worlds of psychiatry and anthropological physiology into union for us to understand the why of trauma reactions and the future unwinding that is now possible. This is a must listen to conversation if you know anyone with trauma history.

Please enjoy my conversation with Professor Porges,
Dr. M

Dr. M’s Women and Children First Podcast #66 – James Greenblatt, M.D. – ADHD

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Attention Deficit and Upstream Personalized Treatments
This week we sit down with Dr. James Greenblatt, a pioneer in the field of integrative medicine/psychiatry. He obtained his MD and completed his psychiatry residency at George Washington University School of Medicine. This training was followed by a fellowship in child and adolescent psychiatry at Johns Hopkins Medical School. He has been studying and educating providers on functional psychiatry for 4 decades. Dr. Greenblatt has served as the Chief Medical Officer at Walden Behavioral Care in Waltham, MA for nearly 20 years, and is an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine and Dartmouth College Geisel School of Medicine.
His focus is on the scientific evidence for nutritional interventions in psychiatry and mental illness. This is the essence of going upstream to right the wrongs of the biochemical pathways of the brain. He is the author of eight books, including the best-seller, Finally Focused: The Breakthrough Natural Treatment Plan for ADHD. His updated edition of Answers to Anorexia was released in October 2021 and his newest book, Functional & Integrative Medicine for Antidepressant Withdrawal is available now.
Dr. Greenblatt is the founder of Psychiatry Redefined, an educational platform dedicated to the personalized, evidence-based treatment of mental health. Psychiatry Redefined offers continuing online education, CME-approved courses, and webinars, and boasts the most comprehensive and scientifically-based professional fellowship for mental health providers, The Psychiatry Redefined Fellowship in Functional & Integrative Psychiatry.
Please enjoy my conversation with Dr. James Greenblatt.
Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 2

Christmas, Tradition and Holidays in General.
When I think about the holidays, I think about large family gatherings, fake birds chirping in the Christmas tree, my Babcia cooking pierogis in butter, bacon and onions and serving me a huge plate, my cousin tripping and falling into the tree trying to turn off the chirping bird. I think of Christmas eve singing Polish and English carols. I remember the long table with 30 people sitting around the room celebrating togetherness. Life was pure as a child. Being the youngest of the generation, I seemed to see everything from the lowest viewpoint. I heard everything that was said that may or may not have been appropriate…………………..plus a piece on genes and mental health. Recipe of the week is here as well.
Enjoy,
Dr. M

Dr. M’s Women and Children First Podcast #36 Nancy O’Hara – MD, MPH – PANS/CANS/PANDAS

This weeks guest is Dr. Nancy O’Hara, a leading expert in the field of basal ganglia encephalitis and pediatric abrupt onset autoimmune neuropsychiatric disorders. Dr. O’Hara graduated with highest honors from Bryn Mawr College and was part of the Alpha Omega Alpha Honor Society from the University of Pennsylvania School of Medicine. She earned her Master’s degree in Public Health from the University of Pittsburgh, and completed her residency, chief residency and general pediatric fellowship at the University of Pittsburgh.
Before she began her medical career, Dr. O’Hara taught children with autism. From 1993 to 1998, Dr O’Hara was a practicing general pediatrician and partner in a group practice. In 1999, she began her consultative, integrative practice for children with special needs, dedicating her practice to treating children with neurodevelopmental disorders, ADHD, PANS/PANDAS and BGE, OCD, Lyme, and Autism Spectrum Disorder.
She recently published a book, Demystifying PANS/PANDAS, a desktop reference on basal ganglia encephalitis. She spends a large bucket of her time training and teaching other clinicians how to treat these complex disorders in children.
This is a very in-depth conversation that is a full pathway of cause to effect and resolution.
Enjoy,
Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 11 Issues 40 and 42

Audiocast #40 – Epigenetics

Humans, like most organisms on earth, grow and maintain their biological systems through a complex interplay between the environment and their genes. Epigenetics is the study of the ability of environmental signals to silence or activate these genes, thus effecting cellular function and species survival. I was once given an analogy, by Dr. Randy Jirtle, that your genes are like a computer hard drive. They do nothing until the software inputs change activity. The environmental signals like food, chemicals, stress and much more are the putative software inputs for us. Good lifestyle inputs have been epidemiologically proven to reduce disease risk.

Audiocast #42 – Stress, Psychiatry and the Intestinal Microbiome

Humans develop disease from many different routes including toxic exposures, genetics, poor nutrition, injury, microbial exposures and much more. One of the biggest risk factors for the development of disease is mental stress. Specifically, chronic stress of the psyche is traumatic to the cellular machinery of the body like the protective telomere tails of DNA strands or the functioning intestinal microbiome.
Enjoy,
Dr. M