On today’s episode of The Spa Dr. podcast you’ll be hearing from my esteemed colleague, Dr. Bradley Bush.

In this episode you’ll learn about Dr. Bush’s naturopathic approach to getting a grip on the all-too-common problems of depression and anxiety.

Dr. Bush and I studied together at The National College of Natural Medicine and since then, Dr. Bush has gone on to co-found and become clinic director at Natural Medicine of Stillwater.

Here’s some of what you’ll learn in this episode:

– How to find and address the ROOT causes of depression and anxiety

– Why OTC meds may be making your problem worse by superfically masking symptoms

– The number one cause of depression in America (you’ll never guess what it is…)

– The importance of measuring vital biomarkers

– The crucial vitamin most people are deficient in that you should probably be taking if you feel anxious or depressed (hint: it isn’t vitamin C…)

What I really love about Dr. Bush’s approach is that unlike most conventional medical practitioners, he teaches you to think in terms of the root causes of your problems.

This mindset shift is what makes the difference between a mediocre bill of health and a vibrant, glowing mind and body.

The Importance of Bloodwork

Dr. Bush and I agree that it’s absolutely critical to get comprehensive bloodwork done if you feel anything short of 100%.

Oftentimes you may not realize that the culmination of stress, poor diet, lack of quality sleep, lack of exercise and mismanagement of your emotions can have profound implications for your so-called ‘biomarkers’.

It’s important to get baseline tests such as:

  • Hormone panel
  • Thyroid panel
  • Liver function
  • Kidney function
  • Electrolytes
  • Complete Blood Count
  • Inflammatory Markers

This last item is vital because as Dr. Bush mentions on the show, the biggest (and least known) cause of depression is intimately related to these values.

Links to Check Out

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Dr. Bradley Bush

I help people who have fatigue, insomnia, & mood disorders find alternative health solutions to reclaim their lives.

Dr. Bradley Bush received his naturopathic doctor degree from National College of Naturopathic Medicine and is currently co-owner and clinic director of Natural Medicine of Stillwater.

Dr. Bush’s practice focus is fatigue, insomnia, mood disorders, and Lyme disease. Previously, Dr. Bush was the co-founder and practitioner at New Hampshire Natural Health where he specialized in neuroendocrinology, intravenous therapies and lower Gi health for 8 years.

Dr. Bush has over 14-years of industry business experience and is owner of Natural Health Insights, LLC providing consultant services to the natural products and laboratory testing industry. Dr. Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology and Lyme disease.

Dr Bush sits on two non-profit boards; Naturopathic Education and Research Consortium and Compass Center for Health and is Co-Chairman for the American Association of Naturopathic Physician’s Curriculum Committee. He lives in Stillwater, MN with his naturopathic doctor wife and four daughters. He enjoys cooking wholesome food with his wife, biking with his children, swimming, and running.


Dr. Cates: Hi there, I'm Dr. Trevor Cates. Welcome to The Spa Dr. Podcast. On today's show my guest is Dr. Bradley Bush, and we're talking about a naturopathic approach to depression and anxiety. It's important to find the root cause of any health condition, and mood disorders are no different. Dr. Bradley Bush was my classmate at the National College of Natural Medicine and is currently a co-owner and clinic director of Natural Medicine of Stillwater. Dr. Bush's practices focuses on fatigue, insomnia, gut issues, mood disorders, and Lyme disease. Dr. Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology, and Lyme disease. Dr. Bush lives in Stillwater, Minnesota with his naturopathic wife Becky and their four daughters.

Let's face it. Many of us or at least someone close to us have struggled with sadness, moodiness, or anxiety. Sometimes we feel like there aren't really any solutions, and sometimes talking with a counselor just doesn't feel like enough. There is a reason for that, and that's why I invited Dr. Bradley Bush on my podcast. Today, we talk about the root causes of depression and anxiety and how to really address them with a more naturopathic approach, so please enjoy this interview.

Bradley, it's great to have you on my show.

Dr. Bush: Thank you Trevor, thank you for inviting me.

Dr. Cates: Yeah. Dr. Bradley Bush and I went to naturopathic medical school together. We were in class together, right?

Dr. Bush: That is right.

Dr. Cates: Yeah. It was a while ago, but you've been busy since we graduated, a little bit busy. Tell us what makes you different than other doctors, especially other naturopathic doctors?

Dr. Bush: Well, I think every naturopathic doctor is different. We obviously went down this unique path for whatever particular reason. Each one has its own great story. My particular story was where I was going to research originally. I had applied for developmental neurobiology research postgraduate. I realized somewhere along the line that maybe I was getting into something I didn't want to do, so I ended up joining a nice yogi cult and lived on a retreat facility in the middle of America for six months, did nothing but yoga and meditation and social service. I ended up volunteering and I went to Haiti to help the local group of patients out there with some yoga teaching, some school teaching, and to help write a grant for a food cooperative down there.

At that point, you realize, there's a big picture of life out there. That me sitting in a windowless room doing research seemed a little self-absorbed and I need to actually get out and help people. At that time I was sort of a premed background also, so I ended up going through it. I was actually researching medical schools, especially alternative ones in Illinois, I grew up outside Chicago, and I dropped the book, the [Barrett's 00:03:22] Guide to Postgraduate Schools. I dropped the book on the ground, when I picked it up. It opened up to this thing called naturopathic medicine. I never heard of a Naturopath until that moment. I read through it, and I said, "Hey, sign me up. That's exactly what I want to do." About three months later I was living in Portland, Oregon and getting ready to school.

Dr. Cates: I forgot about that story. That's great. That's a great story. I love that. It's like sometimes things just land right at your feet, just tell you what you to do.

Dr. Bush: Exactly, exactly, people get little snippets from the universe all the time. It depends on whether or not we listen to it. Of course, later in life, I had graduated medical school, ended up working in the nutritional industry, and eventually found my way to a mom and pop company that was pioneering the application of urinary neurotransmitter testing in a clinical setting and developing a bunch of neuroscience based nutritional solutions. I ended up working with that neuroscience company for, well, ended up about twelve year, seen years as an executive in-house and education and formulator outside of that.

In that time period, I've seen hundreds and thousands, about four hundred thousand test results of patients throughout this country. I have helped thousands of doctors in training them and helping not only in the naturopathic community but also in the psychiatric community, in the primary medical community, even the research community. Helping people put together biological basis behind a lot of our common psychiatric and mood disorders.

Dr. Cates: Yeah, so how is your approach to mood disorders like depression and anxiety? I want to talk about how your approach is different and how you feel about these, because whether someone has been diagnosed with clinical depression or anxiety disorder, or we're just having issues. Everybody gets affected by depression or anxiety at some point. Let's talk about that and what your discoveries have lead you because you're such an expert in this area.

Dr. Bush: Well, first off, first thing that differentiates me at least from our conventional community in my area, which is a very HMO-driven area, and I hate to say this, but the one thing my patients keep telling me is that, whenever they say something to me, I believe them. That seems like such a horrible thing to say, but when patients tell me they have horrible anxiety, that they can't sleep, that they feel that things are crawling under their skin, I actually believe them. I just don't think that it's all in their head. Yeah, it's a manifestation, but it's a manifestation stemming from something.

One of the things that I always tell patients is that I am not into counseling. I am not going to be your shrink. I'm not going to have you lay in the couch. What I bring to the table is the ability to biochemically break down why you may have some imbalances in brain chemistry that are resulting in some of these manifestations that you present me with, the anxiety, the depression, the OCD, whatever it may be. What ends up happening to a lot of these patients, a light bulb turns on and they just see the fact that, "Hey wait," I hear this all the time, and people are crying when they realize, "Wait, wait, are you telling me that I do love my family, that I do love my husband, that I actually do care about my children, that you're saying that there is a measurable biochemical imbalance that actually has lead me to feel this way?"

That alone helps liberate people, because people start believing that there is something hard wired wrong with them, and that's usually not the case. There are some situations, but ninety percent of the people who are placed on antidepressants, or anxiolytics, they only need support for a short period of time. What happens is they end up staying on long-term treatments ... that is what leads them down this spiral of dis-ease and no longer feeling very functional.

Dr. Cates: Oh my gosh, and that's so true. There are so many people that I've helped over the years that they just need a little support, and then life goes on and life gets so much better but you're just needing a little bit of support. It gets so much more complicated though for the people that have been on a number of different medications, psychiatric medications, or sleep medications, or all these different things, gets more complicated to help them once they've been on those. How do you feel about the conventional medical approach?

Dr. Bush: Well, in general, most of the medications are designed to modulate certain neurotransmitters that are very predictive. There are also a number of meds that alter electrical transmission, gate transmissions. At the end of the day, they provide useful services in the short-term. Many patients are not given the ability to have choices, so this is what drives me crazy. When a patient sees me, I always give them all their options. I let them know what a conventional pharmaceutical approach would be, what a natural non-pharmaceutical approach would be, what would a integrated approach look like. We form the best path for the individual.

What really is a disservice to patients is when they lack a medical choice, and they're only told there's one way to go about treatment. That's when you start heading down this world of psychiatric medication. Psychiatric medications, antidepressants, anxiolytic, these are things that are mystical. They don't have mystical properties. They definitely help people out in some profound ways, but at the same token, you need to pull yourself back and ask the question, "Why is that med helping this person in X, Y, or Z fashion, and what is the cause behind that?"

Likewise, is there an alternative approach that may actually have a better long-term outcome, and then you put together an action plan. Most of my patients are on anywhere between one and eight pharmaceuticals for psychiatric issues, and you have to slowly bring people down. First identifying what disturbances they have, figuring out how the medications and some of the other therapies are working together. That has usually helps create a roadmap.

On a biological basis we always look at full biology, and I always like to remind people, and I ask doctors all the time, and I'll ask you Trevor, what is the number one cause of depression in the United States?

Dr. Cates: The number one cause?

Dr. Bush: Mm-hmm (affirmative).

Dr. Cates: I don't know Bradley, what is the number one cause?

Dr. Bush: Inflammatory depression, inflammatory depression is the number one cause of depression in America. Inflammatory depression is depression of chronic disease. When individuals have a chronic medical condition, when you have a state where your immune system is upregulated, or you have a lot of inflammatory mechanisms upregulated, eventually that inflammation leads to biochemical changes that alters your brain chemistry often resulting to lower serotonin and dopamine and norepinephrine levels. That is what eventually then stems from most people's depression.

I always ask this, it's like, "Well, if your general practitioner put you on an antidepressant or your psychiatrist put you on a number of antidepressants, let me ask you this, did they measure inflammation in your body? Have they done an assessment to identify any reasons why you might not be coping with inflammation? Did anybody check any of the common mechanisms in the immune system to understand is there a root cause behind maybe why there's inflammation?" That's where as naturopathic doctors, we look at the whole person, and we look to see all these different possibilities and what might be predisposing them in an infectious, in an immune modulating lifestyle manner.

Then with modern science, we can actually coat over that and layover sort of a genetic markers so we can do ... Now, testing for genetics is now a commodity in the laboratory world and we're able to actually overlay your genetic predispositions with biochemistry markers and figure out some more options for people. Sometimes those options are favorable. Maybe you don't mind being depressed as long as you can still have your three martinis and your gluten. It's a trade-off, so we could at least let you know that is your option versus saying, "Well, no. Just have an SSRI and you'll be fine."

Of course, when it comes to quality of life, people are put on these SSRIs, often times with these antidepressants or even anxiolytics, they feel better rapidly. They actually get better quickly, and so instead of figuring out a way to titrate a person off their med once they're feeling better, maybe replacing some of the serotonin that was lacking which is why the med worked. They are kept on the med, and these reuptake inhibitor medications that are used for depression for the most part, first line, I call these the modern tobacco.

These SSRIs, they're the modern tobacco, because, you know what, you take them, you felt better with them, but the mechanism is designed not to give you more serotonin. You might've been low in serotonin. You take the med. It keeps your serotonin around longer, and it makes you feel better, but what it does is it robs from Peter to pay Paul. It keeps your serotonin around longer in the neural synapse. It doesn't allow it to be retaken back up into the cell for use for later. You might've been low, guess what, now you're getting lower in your storage levels.

Then your body, it's a beautiful thing when those neurotransmitters are out and about, then the body has enzymes to break them down to get them out of circulation, so you deplete them faster. You're depleting what you have, and here you are, you're stuck on it. You stay on it for an extra one or two years longer than you needed to, guess what, you'll have a hard time getting off of it. It's not as vicious and malicious as nicotine, but it is horribly shortsighted to think that this is a long-term strategy when it's designed to actually deplete the body of the very thing that is trying to help mobilize.

Dr. Cates: Yeah, absolutely, and I see that over and over again. Let's talk about testing, a little bit about how people can find out, is inflammation and issue for them, is serotonin low, what is the cause of their imbalance, the reason why they're having the mood disorders, and then I want talk about how we address that, but let's start with testing. What can people do and what should they be asking their doctors for? I imagine what you're going to recommend is more of what you're going to find with naturopathic physicians and functional medicine doctors, but let's talk about that.

Dr. Bush: Sure, sure. Well, first off, everyone needs to have a good snapshot on their overall general health. You need to have a direct measurement of your lipid levels, because if you have cardiovascular issues that are not being addressed, that will lead to low level chronic inflammation. That's not good, and we want to make sure we address that because it's uneasily addressed. Let's also remember, at the end of the day, more people die of cardiovascular disease than any other disease in the United States. We want to make sure that we address that because it helps the foundation.

After that, we also look at their blood sugar level. Once again, if your blood sugar is not correct, your lipids won't be correct, you'll have more inflammation, and it helps with the spiraling of utter control, of chronic inflammation, which eventually can lead to your mental, emotional dysfunction also.

After that, we look at some basic serum test. We look at your vitamin D level. I tell people all the time. The name vitamin D is a horrible name. The molecule vitamin D was discovered when they were discovering other vitamins at the time, that's why it was called vitamin D, but it's not a vitamin. It's, by definition, a neurohormone. It's an important one because it acts a lot like a steroid where it goes right into a cell, it binds to your DNA and creates proteins that eventually go to help maintain and make your nervous system function, an important thing to have.

Even if you live in beautiful sunny park city versus maybe not so sunny and cold Minnesota, you still need to measure your vitamin D, because, guess what, we slather ourselves with sun screen, we put hats on, we have clothes on, and we don't get as much sun. We also have a lot of genetic mutations that have been passed along that for some time prevent us to mobilize and us our vitamin D properly.

On top of that, you want to look for some chronic inflammatory markers, your C-reactive protein, your Lp(a)'s. All these other little markers that could indicate an acute or chronic inflammatory situation, because, guess what, sometimes those inflammatory situations hover down just under the skin and we need to ferret them out. It's also good for tracking mechanisms.

After that, then we take a little step back. Here at our clinic, we pretty much look at a couple of things right off the bat. We usually try to have every patient do some type of a food program, and in our particular case, we usually do a serum IgG food sensitivity test to see what foods they might be reacting to. Then they get put on a guided elimination diet to remove those foods.

What that does is it helps strengthen up your gut, and one thing about your GI tract that people often forget, that eighty percent of your immune system is housed in the intestines. That's eighty percent. If that is not working properly, if it got more an immune activity, more irritations to the immune system, then it creates a lot of inflammation, and it can also lead to a lot of immune stimulation that worsen other situations with patients, especially autoimmune.

After that, we look at neurotransmitters. I tell the patients, "You're often asked how you're feeling by the doctor. Your blood pressure is taken. You might get your blood taken for cholesterol. When was the last time they asked you how your nervous system was running?" That's an important thing to ask, because from as simple at-home urine test, you can measure to see how your neurotransmitters are circulating. Now, those tests doesn't tell me a direct measurement of what's happening in the brain. Different neurotransmitters are measured. Each one comes from different parts of the body. Overall, it creates a beautiful snapshot to see, well how ... and what type of growth imbalances there might be.

I tie that along with a four-point salivary cortisol assessment, because then, identifying your adrenal glands functioning through secretion of cortisol at four times a day, we get a better understanding of how your stress response is working. Now, I tie that to the neurotransmitters that are secreted by the adrenal gland, the epinephrine, norepinephrine, and we put together this beautiful package that gives you an understanding to how you adapt to stress and how you respond to stress.

Ultimately, many people are presenting because they have issues adapting to stress because of huge amounts of stress that have occurred, whether it be lifestyle stress, posttraumatic stress stress, or immunological stress from infection or their disease. This is usually very beneficial for our overall action plan. We also look at hormones. We look at not only the sex hormones but we also look at thyroid. Still a horribly mistreated organ system, both the sex hormones and the thyroid, and we can do wonders with just helping that get a little balance.

Finally, what we've been doing a lot here, because when you family predispositions to depression to anxiety, insomnia, what you bring to the party, your genetic baggage, plays a huge part of it. Of course, when you look at an individual's predisposition to condition, when you look at what genes they bring to the party, and then what type of party the put on. You look at what their genetics are, and then what their lifestyle has been. We overlay that and we can see what their biomarkers, their neurotransmitters, their inflammatory markers, and other things. Well, what might be ticking that could be maybe offset on their genetics.

There's lots of genetics that predispose you to depression and anxiety, and there's a lot of nutritional solutions that can help mitigate those to help, maybe, prevent you from having to be on antidepressants, anxiolytics, or insomnia meds.

Dr. Cates: Great. Very thorough analysis there and testing that you do on your patients. I love it, very naturopathic approach, where we're looking for the underlying cause. We're not just going to give a medication or even an herb or a supplement that's just going to mask the symptom, we're going to actually try and find out what are the underlying causes. You just mentioned a lot of different underlying causes that you can discover through laboratory testing. Just to review that, the first things you talked about were things that you can order on basic blood work, like lipid levels, blood work, I mean, you said blood glucose, and some of things you can order, and CRP, C-reactive protein, right?

Dr. Bush: Mm-hmm (affirmative).

Dr. Cates: Those are things that a conventional doctor often times will order on basic blood work, but then you went in to some specialty lab testing that mostly those are going to be naturopathic physicians, functional medicine doctors that order those types of test. The food sensitivity testing, the genetic testing, the neurotransmitter testing, those are all really specialty labs. I love that you take all that information and then try and figure out what is the issue for that person, because there are so many different possible reasons why somebody could have a mood disorder. It's so important to find out why, because then you can specifically treat the person depending upon what those issues are.

Dr. Bush: That's right. At the end of the day, modern medicine is moving more and more towards personalized medicine. Personalized medicine is not just making a person feel special when they're in a clinic, and then just giving them the same protocol as everybody else. Personalized medicine is breaking down what makes that person tick and what is happening in that person at that moment, and then crafting strategies to their needs and to their specific biochemical and physiological needs. That is the modern medicine.

We're becoming smarter. We're going to get a lot smarter in the future, and in the future with smarter computer systems, more integration of technology, things that we have to do in our brain right now will be pretty much more easily done, but once again, you just still need to make sure it hangs together. R2-D2 is not going to be treating us solely. I think we're still going to have jobs Trevor, but having this extra data, the data is king, and putting this data to good use not just for show and tell but actually working with people to get root cause issues treated improves quality of life, helps people achieve what they want to do in life, improves every aspect.

I have so many patients that say, "Well, I'm no longer depressed, and that's a good thing." It's like, "Yeah, you're no longer depressed, but you also have very little effect, you have no sex drive, your relationship with your husband or wife is strained." That's not a quality of life. Once again, we keep saying quality, because we're on Earth for a finite of period of time, let's make it all count.

Dr. Cates: Right, absolutely. Eventually, you're going to have to get off the medications anyway, and then what? You still need something to do to help balance things, like you mentioned, serotonin. I'd love to get back to some of the neuroscience and the testing that you do to look at neurochemical imbalances. Let's talk a little bit about that, because I think that's new information for a lot of people.

Dr. Bush: Yeah. Neurotransmitters are small little molecules that the nervous system uses to communicate with. We're all very familiar with the most popular one, serotonin, because of Prozac nation, where you take Prozac and your serotonin gets boosted up. We're becoming a little more intimate with the new kids on the block. Maybe you're a Effexor or a Cymbalta that affects both serotonin and norepinephrine, your Buspar that hits your dopamine and serotonin, or maybe it's your Ritalin for your stimulants. Those are amphetamines that boost your dopamine, phenylethylamine, epinephrine, norepinephrine.

Neurotransmitters are something that have been manipulated for eons by doctors for desirable purposes. Neurotransmitters though, typically choosing what to give someone is trial and error. A trial and error thing drives people crazy, because it's like, "Okay, wait, you're going to try this one. No, oh wait, that didn't work, so now we're going to flip over to this med. Oh that one didn't work. Now I'm going to try in these two med. Well that didn't work. I'm going to do this one." Well, it's just a big experiment. Well, it's not even that refined.

There's lots of protocols put in place. Research has been done to try to identify who will be a better candidate for this med or that med. At the end of the day, it's very archaic when you could always simply asses what a person is running like. Now, you might not be a hundred percent accurate in running off of that, but at least you actually narrowed the field down. The testing is basically looking at it through the urine for the markers of neurotra- ...

The neurotransmitters are dumped through your blood into the matrix and into, eventually, to your urine to be secreted out of the body. You capture one of those, a sample. We usually don't do your first sample of the day, it's the second sample in the morning when you're "most calm" as a nice baseline. That particular test or that urine is then measured for the different neurotransmitters. This approach has been used for over sixty years. They have been identifying mechanisms of pharmaceuticals using urinary neurotransmitter testing in research since the fifties. It's only been about fifteen years ago that companies start making them more cost effective for doctors to run out of their clinics.

Currently right now, there's a handful of companies that offer it. The one company that I used to work with that I still use today, they would have over seven hundred fifty thousand samples that have gone through their lab. That creates a huge database that you can pull from. With that, you'd get these normal values. Of course, just because you could measure a neurotransmitter that doesn't mean that there's any help in knowing that number, unless you could base it upon some type of a population.

A lot of times, doctors, we're like, "Well, you want to measure your neurotransmitters? Great, we'll draw your blood and measure your serotonin." Well, that doesn't tell me anything because that blood test for serotonin was calibrated to look for tumors that produce serotonin. Great, everyone is normal unless you have tumor producing high amounts of it, but that doesn't really help me. Likewise, the doctors might actually pull a sample out of the brainstem, shrivel spinal fluid and then test neurotransmitters. Once again, great, there is no normal value on that, because what normal about having a needle pushed into your central nervous system and extract fluid out of it? That doesn't tell me if I'm running the way that I should within that population of "healthy normals."

Having an assessment that then is able to identify how well you're running on each of the different neurotransmitters is huge, because, guess what, if your revving, let's just say your serotonin is at twenty percent of the population. Well, when has your goal ever been to be the twentieth percentile at something? It's really not. I want to be better than ninety-eight percent of the people. You want to be somewhere between that eighty and a hundred percent. Well, no one runs out and says, "Hey, I want to be twenty percent, woohoo." You're not functioning very well. This is what happens to so often with individuals, especially when you have other issues that are layered on to their issues.

Not having the ability to quantify, to objectively look at, well, how a person is reading, puts a patient in a disadvantage. A simple urine test is an easy thing to do. You simply capture the urine. You do it at your comfort of your home as a nice baseline. Whatever is really, let's just say, out of imbalance in that baseline, that creates a nice starting point to help balance out a person.

The brain, the brain is an important thing. We're often fixated in the clinical settings on whatever you can measure and manipulate readily. A lot of doctors specialize in hormone therapies, because, guess what, you give hormones to someone, they instantly feel it and they usually feel good when they're on them. It's not a very refined, and not a very top-down approach. Working with the brain, trying to restore function so that the brain could regulate the endocrine system, regulate not only your sex hormones but your adrenal hormones and your thyroid. That pays off in the long run immensely, and keeps people off of some potentially harmful hormones. Once again, you can take some medications or hormones for a short-term gain, but at the end of the day, if you don't get that root cause supported, it's going to bite you in the end and you'll have more problems down the road.

Dr. Cates: Yeah, absolutely. I love that neuroscience lab. They don't just do the neurotransmitters but they also do cortisol, like you were mentioning, checking for adrenal function, and they also do sex hormones, correct?

Dr. Bush: That's correct.

Dr. Cates: You can have all that tested at once. I love using that for my patients because it makes it so much easier. Although if you're doing the adding the cortisol or the sex hormones, it's not just a urine test it's a saliva test too, correct?

Dr. Bush: That's correct. I work with patients all around the world, and so we'll drop ship the collection kits to them. We have patients in India, and in Hong Kong, and New Zealand, and Bermuda. It's one of those things where it's an actual ... Because it's a non-invasive test, the one that you do at home, not only is it easy to perform, especially even long distance medical work, but then it's more practical. The good example here is a sleep study. How many times have patients gone for sleep studies where they're like, "Okay, well, I'm this strange room with this uncomfortable bed with a bunch of people watching me, and they expect me to fall asleep?" It's not a real situation.

Once again, likewise, for a lot of patients, looking at their stress markers, if they go into an office and they get attached by a needle for a venipuncture, and they get their DHEA and their cortisol measured to look at adrenal health, it may look normal, because now they're in a fight and flight action and those hormones are now elevated versus, they wake up in the morning, they wipe the sleep out of their eyes, they slush downstairs, they eventually start collecting their samples. It's in the comfort of their own home. That's who they are. That's how they are revving. That provides a significant improvement in data to help that person, because at the end of the day, I'm not trying to help a person stay in fight and flight. I'm trying to help person come back to a healthy stable point so they can handle and adapt to stress better.

Dr. Cates: Right. I know with these tests with my patients that have difficulty with sleeping with insomnia, we do the test at night to determine what their levels are at night and what's keeping them from being able to fall asleep at night.

Dr. Bush: Yup.

Dr. Cates: Let's talk about how we address these things. When a patient's test results come back, we're testing things like serotonin and dopamine and epinephrine, norepinephrine, and maybe we put in some cortisol. What do you then do for someone based upon their results?

Dr. Bush: Well, sure, sure, with that we that we take those results. We layer upon some of the interfering factors. We look to see if they're on any type of medications that alter neurotransmitters, and we factor that into the piece. We look to see if they're having genetic predispositions that may either decrease or increase their metabolism and synthesis of neurotransmitters, like an MTHFR mutation that can lead to less serotonin and dopamine being produced, or maybe a COMT mutation that leads to higher levels of circulating dopamine, epinephrine, norepinephrine. You factor those in.

At that point, we then come up the strategy. We look at, "Okay, these are your presenting symptoms. This is your biochemical imbalances. Now we're going to put a plan together that both addresses the symptoms so you can actually start improving quality of life." At the same token, address the root causes, at least in the imbalances, to normalize the brain chemistry to actually start working towards either a removal of certain medications and/or improving the ones that you're currently on, or using them as an alternative to medications.

Dr. Cates: Right. I just want to say a side note, it's really important, and I'm sure you would agree, that people not just stop their medications. If you're taking, anybody out there who's watching or listening and you're currently on a medication, it's important for you not to just stop it after listening to this because you'll want to work with someone to help taper you off, or maybe you need to stay on it for a period of time. I just want to make sure that people know. It can be dangerous to suddenly just stop a medication, wouldn't you agree?

Dr. Bush: Oh, absolutely, and I actually, even with my own patients, I have to work with them to stay on them longer often times, because they get so excited they just want to jump off. As a rule of thumb, I always tell people, "Don't even think about start tapering off the med, unless you felt better for two months on a co-therapy, and then, for every month, for every year you've been on the med, it's one month of titration."

I have a lot of patients on SSRIs or SNRIs for anywhere between ten and eighteen years. Well, I just let them know, think about it as a year to year and a half process of slowly bringing them down, because, yes, technically you can go off of them and there's no "major adverse side effect," but that also sets you up for failure. You might as well move in a straight line towards your goal, instead of trying to jump ahead and then ended up two steps back. That's what happens especially with these different psychiatric meds, you will end up behind if you try to jump ahead too fast.

Dr. Cates: Yeah. The thing is it's important for us to mention that. You're making dietary recommendations. You mentioned things like cutting out food sensitivities and also some supplements and things. Just talk about some examples of things that you do with people.

Dr. Bush: Sure. Well, the GI tract, as I mentioned earlier, is eighty percent of your immune system. Ultimately, there's always a root cause behind brain imbalances. A big part of that is your gut health, your reactions to allergies or sensitivities, and due to imbalances in the gut flora. What I tend to do, the main things that I look at are, okay, we make sure that you don't have any food sensitivities that you're bringing in that are confusing everything. We want to make sure that if you have any damage to the GI tract that we address that.

If a person is not having regular bowel movements, that becomes high priority because you cannot be a normal human unless you actually are having normal human processes. Detoxing yourself is one of those, and that opens up a the door to lots of issues. We have been testing more and more people for small intestinal bacterial overgrowth syndrome, where there is a translocation ... Intestinal bacteria into the small intestine that leads people to think that they have lots of food sensitivities, and results in a lot of peristalsis issues, so constipation or diarrhea.

Because I work with a lot of mental, emotional patients and a lot of psychiatric issues, what I also get to see is the severe SIBO cases where these patients, they are presenting with treatment resistant, anxiety, and insomnia with fibromyalgia, joint pains, and these people have been falsely diagnosed in the conventional world as fibromyalgia, or head cases where they're only given psychiatric option.

At the same token in the alternative realm, because I'm in the Midwest, a lot of these patients are diagnosed with Lyme disease or some other chronic infectious disease and the patients end up on years and years of antibiotics. They feel, sometimes, better on the antibiotic but it's not the long-term solution because it's either not the right antibiotic or it's not the right process. That becomes huge, and so this has been another thing to look at. When it comes to your diet, it depends on if you're eating healthy quality foods, number one, if you're adversely reacting to the foods on an immunological basis, number two, and number three, if you have a dysbiosis in your GI tract that may be reacting to foods you eat causing problems.

Those are the three things that we look at, and we have lots of good strategies to go forward with that. We look at treating them with both botanicals, lifestyle diet and antibiotics and antifungals. It really depends on what is wrong with the person, how severe it is, but it's critical, as you know, as an naturopathic doctor, we always talk about healing from the gut out.

In the psychiatric world, I can't actually emphasize how important that is. I had so many psychiatrist, colleague, friends that have changed their way of doing practice by simply identifying that if their psychiatric patients don't have regular bowel movements, they can never get better. Even just a simple statement like that, a simple approach of first to actually treat constipation, and then they can manipulate their psychiatric meds more. Even just that improves outcomes dramatically, even in a conventional setting, a paramount, very important.

Dr. Cates: Yeah, absolutely. What would you say in your practice would be the top three supplements that you give to people?

Dr. Bush: Top three supplements, good question. I think my number one supplement that my dispensary pushes out, I guess, would be ... I have three, okay.

Dr. Cates: Tell me if you want to go with five, we could do that. I'm totally putting Bradley on the spot here.

Dr. Bush: All right, so there's the Kavinace product that has the 4-Amino-3-phenylbutyric acid. That is a synthetic Amino acid that basically is a GABA that has a phenyl group added to it. It is used to treat anxiety and insomnia. It's extremely effective. It crosses the blood-brain barrier. It works just like that. It works for six to eight hours, so we sell lots of that. It's a great alternative to benzodiazepines and Ambiens, and other meds that manipulate GABA. It's not addictive and you can use it as needed. We used to sell a boatload of that.

Travacor is the 5-HTP product that I use, and because serotonin is often ... I always describe, serotonin is like the brakes in a car. If your car is constantly moving all the time and revving, going fast, fast, fast, you're always applying the brakes. Well, eventually those brake wear out. Well, the 5-HTP is like giving you new brakes by giving you more serotonin. I call it the multivitamin of the modern life, because we're always under stress. If you don't replace some of that serotonin, you're not able to adapt or handle the stress. We sell a lot of that.

Then i think the third one would be berberines. There is a plant constituent called berberines, and berberines have been used historically in the Western world as an antimicrobial. We use it in quite large quantities for intestinal dysbiosis, but it also has a great quality to also decrease synthesis of lipids in your level. You can decrease cholesterol levels by taking it. At the same time, and I like to say, it basically feeds three birds with one seed, it also then have been shown to re-synthesize insulin receptors. Hey, decrease cholesterol, you can get people offset in meds, which are horrible classification of meds. You can help them with insulin resistance. At the same time, you can improve their gut function. Well, yeah, we sell a lot of that.

Dr. Cates: That great. Just to clarify, I know you don't give those three things to everybody. There are just people watching and listening, these aren't necessarily going to be your supplements, but I just wanted people to have an idea of the kinds of things that you give people and the kinds of treatments that you do. Dr. Bradley, it's been so great talking to you, so much information that we've covered today. Tell people how they can find out more about you.

Dr. Bush: Sure. Well, thank you Trevor for having me on your podcast. This has been wonderful. It's wonderful interfacing with you. I miss you a lot. We saw each other every day for four years, and you have yet aged. It's amazing. I have, but I have four children. I know that you only have three. You can reach me, my clinic website is www.stillwaternatural, that's S-T-I-L-L water natural.com. Feel free, we have a lot of things on the website to look through. It highlights a lot of the things we do at the at the clinic.

Likewise, a lot of people want to find, maybe, a doctor near you that do some things that I do also. You can go to the Why Neuroscience, so that why, W-H-Y, neuroscience, N-E-U-R-O science.com. You can click or make a phone call and get a referral to a doctor that maybe uses urinary neurotransmitter testing near you. That may give you a good in on someone that can maybe help you with your own personal needs.

Dr. Cates: Excellent. All right, well, thanks Dr. Bradley.

Dr. Bush: Thank you Trevor, take care.

Dr. Cates: I hope you enjoyed this interview today with Dr. Bradley Bush. To learn more about Dr. Bush, you can visit my website. TheSpaDr.com, go to the podcast page with his interview and you'll see all the information and links there. I invite you to join The Spa Dr. community on my website, or subscribe to the podcast on iTunes so you don't miss any of our upcoming shows.

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