Core Psychiatric Practice Is Changing
We used to think the only way to address complicated mental health conditions was to just keep trying different medication based on superficial diagnostic speculations. The world, my friends, is changing dramatically – just a bit to fast for some. The old medication way left many patients feeling like Guinea Pigs, a phrase so often brought up in outpatient psychiatric practice.
The short observation: No one wants to be a Guinea Pig with psychiatric medications. The new way introduces more brain and body evidence to look at the biomedical causes of the psychiatric presentations. Outpatient experimentation is slowly decreasing, evidence based treatments are on the rise. The new brain and body technology helps with diagnostic and treatment accuracy, creating more predictable outcomes.
Measurement is the new psychiatric watchword, unless you're in complete denial. And measurement is increasingly affordable.
IgG Measurement Significantly Changes the Guinea Pig Factor
One of the most important new measurement discoveries is the relevance of immunity issues, allergies, that effect brain function. These allergies to common substances, often foods that we love, are cost effective, useful and often dramatically helpful. Think gluten sensitivity, casein sensitivity just for starters – and in my office eggs are also significant challenges.
I've been telling you about gluten and casein sensitivity measurement for years now, and have been advocating testing for these food challenges ever since I saw the relevance in my own practice. The challenge with that IgG testing is understanding just how it works, how to read the testing and how to apply it to everyday office practice.
Antibodies Matter
Since many are beginners in this whole brain immunity question I am leaving this brief [6.02m] audio here to point out some of the controversy with IgG testing vs the more accepted IgE. Enjoy:
Stay tuned for more on this challenging subject. ADHD and immunity will be the focus of my NeuroScience presentation in San Francisco this coming Saturday.
While you're at it, sign up for the RSS feed on these CinchCasts:
cp
6 Comments
I encourage those activities, but don’t structure them myself… only so much time. We all support referrals in that regard, and see significant value in Neurofeedback and EMDR as indicated.
cp
What are you doing with meditation and or breath work?
CinchCast is only audio, not a video tool, sorry!
The video does not work!
Dr. Parker,
It’s amazing to me that you made this post this week and I find it this morning, when I was just researching this yesterday! I think the key is like what you say in the cinchcast — acute vs chronic conditions. The more I read and understand about the immune system, I am convinced I have some issue with something, but I don’t know what it is. I am having allergy testing done this week (ordered by my ENT, not sure if it’s going to include food or not though) so I will see what that turns up…but even then I am prepared that it may not be very conclusive!
In looking at the IgG and researching the testing and whatnot, part of the conclusion I’ve reached is that there have not been a whole lot of studies regarding it as an indicator for food intolerances. Given your knowledge and experience in the matter, and desire to improve people’s lives through science, I would challenge you to look into joining/initiating research studies in this matter. Anecdotal and clinical experience is certainly valuable, but one of the problems with soooo many things (for lack of better word) is that it’s all they have with no or very little research basis. Someone who is educated is not going to make decisions based on someone else’s experience, but rather on what the scientific field has been able to demonstrate over time is effective. But in order to do that, it takes individuals who are using it (whatever “it” happens to be) to develop reliable and valid studies.
Considering reliability and validity with IgG testing for food intolerances, I’ve learned that much of it depends on the lab. Especially when it comes to validity. Can you recommend or are you familiar with any other labs that do this testing? I’m in Arizona, so that would be preferable… I’ve also found that IgG testing is done for certain conditions to discover antibodies (such as Helicobacter pylor) and that that is generally widely accepted.
I’ve kept a food diary, and have never found any pattern. Sometimes i can eat things and be fine, other times, not. It’s very difficult to ascertain whether it’s an intolerance, a reaction with some other food or medication, or some virus going around. It’s also not very often for me. I was wondering what you would have to say about greasy foods and a lot of sugar. Those are two things I’ve found that I can’t handle at all anymore — which is not a bad thing! — but is that because I’ve gotten used to eating healthier….so now occasionally, when I do go overboard, I feel sick?
Again, I’m just trying to figure the best way for me to go about this — within the confines of current accepted standard practice, but being knowledgeable and pushing the envelope for the best care so to speak….as well as keeping in mind cost and insurance coverage (only in state labs at the most). My plan currently is to wait for the testing results I already have scheduled, see how they come back, talk to that dr, and slowly go from there. But if you have any words, or thoughts on other labs that do this testing that you would consider valid and reliable, I sincerely await them – as well as your general comments!
Most of the labs, including LabCorp for example, do IgG studies. The real problem is with the reading, as many docs don’t feel that the findings are valid and thus simply don’t know how to apply the results effectively. Often the doc discounts their own impression and falls back on the lab, and if the lab says its down at Level II or in the 15% range, that it really is not significant – this is where the problem comes in – not with the science itself, but the individual doc’s relationship with the science.
Reading becomes a problem also as so many absolutely wish to keep on their counterproductive diet. Just yesterday I had two folks just break down and cry vigorously, then get mad that they had to stop milk, and couldn’t continue with cheese and ice cream. It was catastrophic… and I know from my own experience that many simply don’t want to put themselves through all that emotional food related sturm and drang without sufficient experience and so many simply not recognizing the remarkable psych relevance of chronic conditions. The reading, in a word, is the real issue, not so much the science.
cp