Natural Solutions for Depression and Anxiety with Dr. Peter Bongiorno: Rational Wellness Podcast 436

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Dr. Peter Bongiorno discusses Natural Solutions for Depression and Anxiety with Dr. Ben Weitz.  

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Podcast Highlights

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Dr. Peter Bongiorno is a Naturopathic Doctor and Acupuncturist and he is the co-director of InnerSource Natural Health and Acupuncture, with offices in New York City and on Long Island.  He also works with clients around the world via phone or Zoom.  Dr. Bongiorno did research at the National Institutes of Health in the department of Neuroimmunology and then went to Bastyr University to study naturopathic medicine and acupuncture.  He wrote a number of books, including Healing Depression in 2010 and Holistic Solutions for Anxiety and Depression in 2015, both targeted for physicians, as well as How Come They’re Happy and I’m Not, and Put Anxiety Behind You: The Complete Drug Free Program. His website is DrPeterBongiorno.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz:  Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com.  Thanks for joining me, and let’s jump into the podcast.

Hello, Rational Wellness Podcasters. Today our topic is an integrative approach to depression and anxiety with Dr. Peter Bonjourno. Depression, according to the Mayo Clinic, is a mood disorder characterized by a persistent feeling of sadness and loss of interest.  In 2025, 18% of adults in the US report currently being depressed. While 28.5% of US adults have been diagnosed with depression sometime in their life, anxiety is characterized by feelings of worry, nervousness, or fear that are strong enough to interfere with one’s daily activities. Anxiety is even more common than depress.  With 19.1% of US adults having experienced an anxiety disorder in the last year and 31.1%, having experienced an anxiety disorder sometime in their lives.

Dr. Peter Bongiorno is a naturopathic doctor and acupuncturist worked. He did research at the National Institutes of Health. He went to Bastyr University to study naturopathic medicine and acupuncture.  He wrote a number of books including Healing Depression, Holistic Solutions for Anxiety and Depression, which I have right here. And [00:02:00] this is one of the best books ever written on a topic and a

Dr. Bongiorno:  Oh, thank you.

Dr. Weitz:  Great reference. I use it all the time. As well as how come they’re happy and I’m not.  And also put anxiety behind you, the Complete Drug-free program. So welcome Peter. Thank you. So great to be back here with you, Ben. Absolutely. So it’s often stated by the mental health and medical community that mood disorders like anxiety and depression are not curable, but can be managed with medications and talk therapy.  Can you state the case, why this is not the case for all patients, and why an integrative/functional medicine/naturopathic approach can be important for helping such patients?

Dr. Bongiorno: Yeah. Yeah. Well, to say something’s not curable is you know, it’s an interesting phrase and in a way I’m not sure [00:03:00] exactly what that means or not, doesn’t mean Right.  You know, when I think about somebody’s symptoms it’s the body speaking to us. You know, in some fashion to tell us something that something’s out of alignment, out of balance here, and something that we’re outta balance with the environment around us, you know? So, and in most cases, something can be done about it, you know, it takes a second and there’s things they have to do to figure it out, but typically something can be done about it.  And so in the case of mood, anxiety, depression focus issues, those are the top three, right? People typically have you know, it’s the body telling us something. And I know when we go to a conventional doctor, typically they’ll look at you and say, okay, you know, maybe we’ll try an SSRI which is a drug to increase serotonin or maybe we’ll try a drug that increases dopamine or a drug that increases gaba, which is one of the [00:04:00] calming neurotransmitters.

And sometimes that works. And you know, and truthfully, if somebody you know, and if there’s anyone listening who wants to hurt themselves or isn’t in a safe situation, then of course, you know, go to the psychiatrist go get help. Sometimes drugs can be lifesaving in urgent care situation, so I’m not against the drugs.  But you know, when you look at the research, it’s very clear that most prescriptions. Are used in these mild to moderate cases and the underlying issues aren’t really looked at. And that’s where I think, you know, naturopathic medicine, functional medicine, holistic care, integrative care really shines because we look at the underlying issues to try to say, okay, even if the drug worked.  In this urgent care situation, serotonin came up and people didn’t, don’t want to hurt themselves anymore, which is a beautiful thing. Now we have to ask, okay, well why was serotonin [00:05:00] low? You know, why was the body lowering it so that they would feel this way? And what else can we do to support the body to do that?

Dr. Weitz: Right? And I, I think when they talk about curable we’re thinking about. Another, we’re thinking about a condition that has a possible cause, like you’re sneezing or coughing or blowing your nose and you have a sinus infection and it’s caused by a germ and you can possibly, your, either your body can do it or you can take something that can make that germ go away, and then you’ll no longer have those symptoms.  And I think that’s what we mean by curable. Not that you won’t have another episode sometime in the future, but at least for a period of time you’re not simply managing the condition. Right, right. By taking a medication that now you would expect to take the rest of your life.

Dr. Bongiorno: Yeah, no, that [00:06:00] makes sense.  And I think, you know, when it comes to mood and the word cure, you know, once we understand what the underlying issues are that we’re dealing with and we work on them, then I think a person doesn’t have to suffer with those symptoms.

Dr. Weitz: Right. So what you’re saying is essentially is there’s a physiological imbalance that potentially can be corrected that.  Will actually help the person to feel better and yeah. Not possibly not need medication anymore.

Dr. Bongiorno: Yes. And what I’ve even learned in my own life and what I’ve seen with other patients is when things come back, it’s not because you’re not cured, it’s because your body’s saying, Hey, there’s something.  Outta balance now, and now I’m telling you again. Right. You know, and maybe it’s the same issues from before that we need to readdress. Maybe it’s other issues that are new because the body has shifted a little bit. Right. You know, what I’ve learned is we, you know, with patients over the last [00:07:00] 23 years that I’ve been in practice.  I’ve learned that people’s bodies tell them something and for everybody it’s different. For some people it’s, it’ll come out as anxiety. Some people it’ll come out as constipation. Some people it’ll come out as palpitations. Some people it’ll come out as pain. Everyone, we’re all different.  Genetically and what we’re predisposed to. And, but the bo but one thing we’re all similar is the body talks. And if we’re listening, you know, it’ll tell us things.

Dr. Weitz:  And you mentioned the use of medications that modulate neurotransmitters. And we have this neurotransmitter imbalance theory.  What causes depression and anxiety, and it’s generally thought that if you have depression, it’s ’cause you have low serotonin. And we simply need to help raise the level of serotonin by, for example, using a selective serotonin reuptake inhibitor like Prozac, for example. And that will increase the serotonin levels and then you no longer have depression. But as you pointed out. Sometimes another neurotransmitter drug could be effective and there’s even a drug that reduces serotonin levels that seems to be equally effective. That’s right.

Dr. Bongiorno: That’s very true.

Dr. Weitz:  At this point we probably should conclude that trying to diagnose the cause of depression and these other mood disorders.  By just seeing it as one simple neurotransmitter being low or high. I think I is not gonna, is not an accurate way to understand it. I think the balance of these chemicals is very complex and at this point I don’t think we really have a clue what we’re doing.

Dr. Bongiorno: Yeah. I, you know, it’s interesting if you the research is pretty [00:09:00] clear about when somebody has depression.  You know, the drugs work about 25 to 35% of the time, which is a little better than placebo. So it tells you, you know, if you take that at face value with no other factors that you’re thinking about, you know, maybe around 20, 30% of people who have depression do have low serotonin, and for them it works. And for 70, like you mentioned, there’s another drug.  A lot of people don’t know that there’s another drug, I think it’s called Stab Lon. Yes. That they’ve studied. And they actually lower serotonin and they’ve noticed it works about the same percentage, which just tells you, yeah, sometimes it’s high, sometimes it’s low. And in those patients you give them an SSRI and they actually will get more agitated and the mood gets worse.

So it’s and that tells you something. It says okay for them. It’s not a serotonin issue, it’s something else, you know? Right. So, you know, I find when most of my patients, when they come in, they’re already on medications [00:10:00] and if I hear a medication really helps. ’cause sometimes the patient will say, oh my gosh, I took Fluvoxamine for my obsessive compulsive disorder.

Boy, it was like a light came on, it really worked, you know? And then that tells us, okay, that is. An important neurotransmitter for this person. It helps them feel better. And now we wanna get to the underlying root. Like what is the reason their serotonin dropped? Is it gut issues? Is it inflammation? Is it nutrient deficiencies?  Is it hormonal imbalances? You know, so, so that gives us a chance to start looking into all those things. So for those of you who are out there who are on medications and you think they’re working or working partially, you know, I’m not saying stop them and they’re evil or something. You know, I’m glad they’re helping, but here’s the opportunity now to really do some testing, to really talk about it and to really say, okay, where did this change happen in my body?  Now what can I do to really work on it?

Dr. Weitz: Right. So [00:11:00] how do you approach a patient who comes to see you with depression or anxiety? What are the first things you ask them?

Dr. Bongiorno: Yeah. Well, it’s a, it’s a. You know, my first question, believe it or not, is for most of my patients is if if I could wave a magic wand and just make something better or more balanced, you know, you know, I’m thinking magic wand.  I like, that’s probably what a lot of conventional doctors will worry about, that they go see a naturopath and there’s an actual wand, you know. Anyway you know, so if I could wave a magic wand and make things better or more balanced, what are the things, the thing or the things in priority that you would like to see?  Just get better, you know, because when I hear about depression or anxiety, it’s a diagnosis, right? There’s a code for it and it helps it get through insurance coverage and all that, but it doesn’t explain much. So what I’m interested in is, you know, when the rubber hits the road, [00:12:00] like what the person that I’m working with, who’s in front of me, or I’m talking through, you know, virtually, what are they really suffering with?  What’s really bothering them? That needs to be traversed. So, ’cause that usually gives a good clue on how to start helping. And then after that, you know, we go through the whole history of what, you know, what this person has lived through. And then I like to talk about a person’s schedule.

You know, like what do they have to do during the day? What’s their work life like? Do they love their work? Go through a whole review of systems to talk about any other medical issues, what’s going on with skin and digestion and you know, everything, if they’re taking any other medications, any other supplements.  I really like to hear it all. What are they eating throughout the day? Are they exercising? If not, what are the challenges to that? Because it’s not just a question of me saying, oh, okay, well you have to eat better and go to bed earlier and drink water and, you know, those are all fine, [00:13:00] but in reality, is that gonna be even realistic for this particular person?  You know? So, you know, you mentioned before as part of the definition of depression, you know, something about like not being motivated to go and do the things you know that people want to do in Chinese medicine. They look at it from a heart perspective and they look at it from a liver perspective.

In Chinese medicine for depression, when it’s a liver issue you know what you wanna do in life, but it is hard to motivate to go out and do it. And when it’s a heart issue in Chinese medicine. So again, for those listening, it’s not that there’s something physically wrong with your liver or your heart, but energetically, right?  And this is thousands of years old way of looking at mood when it’s a heart issue or a she issue, then the person. Just doesn’t typically have hope and doesn’t even wanna do anything. So there’s the people who, yeah, you know, if I [00:14:00] felt better, I would go back to school and I would learn, you know, I would learn this and, but I just can’t get myself outta bed.  And then there’s the people who go, oh, it doesn’t matter. It’s nothing I want to do. You know? So, and you know, and it helps from a Chinese medicine standpoint to differentiate because there’s even herbs and mechanism things that you can look into, you know, depending on. That way of kind of deciphering the mood issue.

Dr. Weitz:  Right? So part of what you’re saying there is that there’s not one depression. You have patients, people who are depressed, but one person’s depression is different once they start to describe exactly what it means for them than somebody else’s. Even though we give them all the same diagnosis.

Dr. Bongiorno: Right.  Right. And you know, if you look at my book, unless I kind of messed up, I really do my best not to write the depressed patient. I’ll write the patient with depression, right? Because a lot of people, you know, [00:15:00] get diagnosed and their psychiatrists will say, well, you’re a depressed patient now. And then you take that on and then that becomes who you are because, you know, it’s like, oh no, this is me.  I’m not gonna deny it. And what I like to do is also differentiate. ’cause you know, words are powerful and it’s like you are a patient with depression and that can change. You could be a person with good mood. Right. So it’s

Dr. Weitz: Yeah, I think that’s unfortunately one of the problems with the way medicine is practiced in the United States, where we focus on this diagnosis, and I think part of it’s done for insurance purposes and things like that, but I have noticed as a sports chiropractor and functional medicine practitioner that over the years that patients will get a diagnosis and they’ll walk in the office. Basically with the science saying, I have fibromyalgia, right? Do you know how to treat fibromyalgia? That’s me. You know? Right. And you’re [00:16:00] right.  When they own that diagnosis it’s not really a healthy attitude to have and Right. And it’s an understandable one,

Dr. Bongiorno: you know, ’cause you’re suffering and somebody you’re suffering. If you want to, you what you have and you say, okay, this is it. Right. But it does suggest, I think, a deficiency in how the conventional care system looks at it.  And again, you know, I bless the conventional care system, you know, for acute issues. For emergency issues. Absolutely. You get an accidently, you get a heart attack, you know, God bless ’em, they’re there and they save lives every day. But for things like this, unfortunately, sometimes it can kind of keep the dysfunction going.  Right? And that’s why you exist and that’s why I exist ’cause Right. We’re offering another perspective to really sit down and look at that. Right. So what role does diet play in mood disorders? Yeah, so, so diet is, you know, I remember when I was in in school, this is probably 26, 27 years ago, we had a, [00:17:00] one of the founders of BAS University in Seattle was a very famous well-known doctor named Dr. Bill Mitchell. He was a naturopath. I don’t know if he knew bill Mitchell. I don’t think I ever met him. No. He was a wonderful man. In fact, his plant medicine book is still out there and I think it’s phenomenal. Anyway. And so he was very much about biochemistry and understanding how things worked.

And, but I remember when he taught one of his first classes, he taught us we took, you know, at least a year of nutrition, I think it was a year or more. And he taught us, you know, he said that when you eat a carrot, it’s not a carrot, it’s information. It’s information that, that is related by, you know, the phytonutrients, the chemicals in the, in this carrot.  Right. And it goes all the way into the cellular level, and then it goes to your genes and it talks to your genes and it tells your genes. It turn things on and turn things off and, right. And that was the first time I ever thought of food that way, you know, because it’s like, wow. Yeah, you eat it, it [00:18:00] burn, you burn fuel and this way you live.  Right, right. But it’s so much more, it’s really. Information that our body takes in.

Dr. Weitz: Yeah, I got that same message from Jeffrey Bland from going to his seminars for so many years.

Dr. Bongiorno: Yeah, exactly. Well, you know, Jeff Bland, Bill Mitchell, one of my other teachers, Joe Pizzorno, they all kind of hung out together.  Yeah. And help coin the phrase, you know, functional medicine. Jeff Bland came up with the phrase, but it was through that experience with Bill Mitchell and Joe Pno. So those guys, you know, so Joe and Bill went and founded Naturopathic medicine. Jeff Bland went, founded Functional Medicine more, you know?  Yep. Yeah, it’s, yeah. So it all comes from that same beautiful spirit. I love Jeff Bland’s work.

Dr. Weitz: So what foods should patients who have. Mood disorders focus on eating and what food should they avoid? Yeah.

Dr. Bongiorno: So, without knowing a patient, ’cause everybody’s different. So, and you know, we’re talking to a lot of people here and of course I don’t know them.  If I had to pick one [00:19:00] diet, I would probably start with some version of the Mediterranean diet. There’s a group, a team out of Spain called Sanchez and Vega’s team, and they did a lot of work start starting in the early aughts, you know, the early two thousands when they started looking at the Mediterranean diet.  They looked at it in terms of inflammation in the body, in terms of anxiety and depression and what they showed repeatedly study after study and then this has been verified by other groups, is that a good Mediterranean diet can both help prevent and treat anxiety and depression. It does so through a number of mechanisms.

Some of the mechanisms are just the quality of the food nutrients are very good co-factors to help you make neurotransmitters. Part of it is because it helps the good bacteria in your gut stay healthy. And when that gut bacteria is healthy, it sends signals through the vagus nerve, [00:20:00] cranial nerve 10 from the gut to the brain to tell the brain to stay in balance and to have the neurotransmitter stay in balance.  And then it also is very important. For inflammation in blood vessels. And it’s been shown that anxiety, depression, mental health issues oftentimes has a pretty strong inflammatory component. So there’s at least three mechanisms there that the Mediterranean Diet addresses them all.

Dr. Weitz: So very powerful.  So what do you see the ME Mediterranean diet as focused on?

Dr. Bongiorno: So, that’s a great question. ’cause there are different versions, right. And I would say for me,

Dr. Weitz: That’s why I phrased the question like that.

Dr. Bongiorno: Yeah. So the first thing I think of is water. Making sure people are drinking enough water.  You know, when we don’t drink enough water, tryptophan doesn’t get into the brain at the same rate it should to get converted into serotonin. So water and hydration, you know, the brain is made of fat and water. If we’re not [00:21:00] drinking enough water, we’re not hydrated. It’s very hard for the body mental processes to work properly, right?  So, so even before the diet, I think about water. And then when I think about the diet, I just think about really good quality. Fruits and vegetables, especially green vegetables. You know, I know when I go to Sicily, you know, visit a family in Sicily that, you know, there’s a lot of green vegetables and it’s all fresh, you know?

Yeah. And there’s fruits, there’s vegetables, a lot of olive oil, like really good quality stuff. Right. So I think that’s the centerpiece of it. And then there’s a fair amount of fish. Sometimes there’s meat, but usually the meats are, you know, grass fed, organic a little bit of dairy, not too much dairy.

Yogurts can be a part of it. You know, yogurts can be very healthy and a lot less inflammatory than the other dairy foods. Raw nuts and seeds are a big part of it. So, all of those beans, of course beans are an important part of it too. And so it’s just a nice [00:22:00] mix of all those, you know, and when you eat food that way, you have nice bowel movements every day.

And, you know, bowel movements are really important because your liver is always putting out excess hormones, excess cholesterol, and what is it? Dump it, it dumps it into the intestines. And then if there’s enough fiber in the intestines, it pulls it out and you get rid of it, you poop it out. And so in that, and that’s how keeps the body in balance.  So you’re getting all the nutrients in, you’re getting rid of what you don’t need. And that, that makes the body healthier. And and the body rewards us with good mood, you know, because we forget wine is

Dr. Weitz: often part of the Mediterranean diet. Is that good or bad for mood?

Dr. Bongiorno: Yeah. So, you know, so especially lately, alcohol’s been.  You know, more talked about, and I’m glad it’s being talked about. ’cause I think for many years it was only considered kind of healthy. Right? Especially for the cardiovascular, right? Yeah. It was like his one,

Dr. Weitz: like one glass a day was Yeah. Good for the heart. And it was the whole French paradox. And

Dr. Bongiorno: That’s right.  And [00:23:00] I’ll tell you, I mean, it’s interesting because, you know, my mom, you know, my mom, I remember my mom and dad. My, my dad’s 91, my mom’s like 87, and they had some. Some kind of drink almost every day, whether it’s a glass of wine or a little Manhattan before a meal and never drunk, of course. Just have a little bit and my mom’s HDL is good.  Cholesterol is probably the highest it’s ever been I’ve ever seen of anybody. It’s like in the hundreds. So I think there is something to that. But having said that you know, we do also know that alcohol in any amount can contribute to cancer. So I think if somebody, if a female is more prone to breast cancer, if a male is more prone to prostate cancer and the risk is high.

Then I think even that one drink a day can be more than is healthy for that particular person. Right? So, you know, so what I tell patients is, you know, like I used to tell my daughter’s 17 now when she was little, I used to say, you know, [00:24:00] it’s if you want to have candy. ’cause every kid loves candy, right?

It’s gotta be an occasional treat, not a regular everyday thing. Right. You know, so that’s, you know, that’s where I kind of land on, on alcohol in general. I think wine is probably healthier. I personally don’t get a good sleep with wine, so I tend to keep it out because I notice it affects my sleep. So that to me isn’t worth it.

But you know. But if, you know, if you have it every once in a while and it doesn’t seem to overtly hurt, then it’s probably okay. But I worry for people who have, who are predisposed more to certain cancer risks. So what about coffee? Well, coffee, I have some right here. And so, I am a fan. I definitely recommend organic coffee, low mold coffee, and if you.

If a person has anxiety and they’re having trouble sleeping, then maybe coffee isn’t the best choice. You know, if they have gut issues and their stomach [00:25:00] lining is thin and it bothers them and it gets irritated, so you have to know yourself. Like for me personally, I do really well with coffee. It lifts my spirits, you know, effect.

If you look at the research on coffee, people who who drink one to four cups of coffee a day actually do better. In terms of anxiety.  Okay. Yeah and I mean, I’m sorry, in terms of depression, right. But if they have like six or seven or eight, then it’s no good. That’s too many. So, so I think coffee has a lot of health benefits. I just recommend no, no milk, no sugar, you know, just try to learn to drink it.

Dr. Weitz: Probably not as good for anxiety though, right.

Dr. Bongiorno: Well, you know, it’s interesting. It depends on the person, right? You know, it really depends on the person, right? I would say for most people in while I’m working with them, I tell them not to have coffee if they have anxiety right. And then we bring it back in and see how they feel with it. There are, you know, I wrote a blog.  Once [00:26:00] it’s on psychology Today, and it talks about how for some people who have anxiety, there can even be benefits to caffeine to some people, right? 

Dr. Weitz:  Like some people get anxiety where they can’t get out of bed, they can’t get motivated to do anything, and maybe somebody with that.

Dr. Bongiorno: Yeah. And it

Dr. Weitz: can raise

Dr. Bongiorno: their dopamine, right?

And then things that they were kind of fearful of doing, they get more motivated to do and they can. So it’s, so there are a subset of people with anxiety who, you know, while most people don’t do well with caffeine, that group actually can improve. So it’s just depends, like everything else Depends on the person.  Yeah. Everybody’s different. It’s

Dr. Weitz: popular in a world of natural healing for mood disorders to talk about. A low carb ketogenic diet. What do you think about that? And yeah.

Dr. Bongiorno: Yeah. So that’s certainly something that’s been talked about for the past few years. Yeah. There’s a fellow named [00:27:00] Palmer who has a book called Metabolic Psychiatry.  Yes. Yeah, I think there’s a lot of validity to do where I’ve seen it in my practice do its best work. Are people who have especially high levels of certain neurotransmitters that get things like psychosis and schizophrenia and things like that. Right. I’ve seen it work for depression sometimes for anxiety as well, although I’m always careful because.  When you lower the carb level for a number of people, sometimes that actually lowers serotonin levels. So if serotonin is important for them, then you can actually see their mood get worse. So I always recommend. You know, if we’re going to do this, we wanna start slow and see how you feel. But I have seen fairly remarkable results using some version of a ketogenic diet for different types of mood issues.  Absolutely. Yeah. I

Dr. Weitz: think the thought is brain, the way the brain functions. If you can get the brain [00:28:00] drawing its energy from ketones versus sugar, then Right. Some of the data indicates the brain functions better.

Dr. Bongiorno: And you know, the first data about that was actually in people with epilepsy, right? Where they would use a ketogenic diet and they noticed when the ketone levels came up, some of the calming neurotransmitters came up with them.

Dr. Weitz: Right?

Dr. Bongiorno: And that seems to be that mechanism there. And now we’re just applying it to other brain issues than just epilepsy. And it makes a lot of sense.

Dr. Weitz: And of course following a low carb diet may be part of trying to balance the blood sugar and blood sugar problems can be an issue for, right.

Dr. Bongiorno: Yeah.  ’cause a lot of people, especially with depression, there’s a lot of issues that go on with cardiovascular disease at the same time. And you’re really working on both. You’re balancing insulin, you’re balancing blood sugar, cardiovascular disease, as well as the mood issues. A hundred percent. Yep.

Dr. Weitz: Yeah, because if you’re not getting good blood flow to the [00:29:00] brain, then yeah, it’s hard to have a good brain mood function.  

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Dr. Weitz:  So what are some of the most important labs to look at?

Dr. Bongiorno: Yeah. So again, everybody’s different, right? So, that’s why a good conversation before we run labs is very helpful, right? So you can visualize the recommendations for that patient.

I like to look at blood sugar, insulin sensitivity. You know, an [00:31:00] anything that has to do with anemia, like low hemoglobin, low red blood cells, low iron, high iron thyroid function inflammatory markers which include general ones like CRP and more specific ones like homocysteine, which looks more at the blood vessel inflammation.

And then of course things like other like histamine for example histamine I think is one of the one of the processes in the body that can really contribute to mood issues and is not very thought about often. I find that’s very helpful. Now it’s hard to test for

Dr. Weitz: histamine, correct?

Dr. Bongiorno: Yeah. Well, I’ll look at well first of all. When you listen to a patient’s story, right, you know, if they have seasonal allergies if they’re put on a lot of antihistamines for different kinds of symptoms, if they get kind of blotchy and red while you’re talking to them about important issues, right?

Or if they tell you they get hives and, you know, so there’s a few ways to [00:32:00] check even without a blood test or a urine test. But then blood work. If it shows a positive, you know, there’s histamine issues. If it’s negative you might not have caught it at that time. So it doesn’t mean it rules it out.

A urine, a 24 hour urine could be a little more accurate. So that could be helpful sometimes, but again, you have to catch it, right? So, right. So that’s where the intake really, the, you know, talking to the patient and really getting to know them is important too. And then I look at a lot of nutrients and vitamins.

Which are the most important nutrients you like to look at? Oh, all of them. I feel like the list I’ve, my list is like increased. I’ve gone over the years. You know, vitamin D, magnesium, zinc, copper, manganese all the B vitamins, fo you know, it’s Omega-3 iodines important. What’s that? Omega threes.

Omegas. Yes, absolutely. Look at omegas. So they. They all do different things and and they’re all important as to be in balance. [00:33:00] And then finally, depending on the our discussion, if I suspect it, then we look at other testing that looks at mycotoxins, that might look at mold and mycotoxins that look at heavy metal you know, toxicity.

So it just, it’s just gonna depend, you know, gut stool tests,

Dr. Weitz: right? Hor,

Dr. Bongiorno: you know, more involved urine hormonal tests to look at the hormones and melatonin and cortisol and adrenal function. Very important, I think for most cases of mood issues. You know, there’s so many tests we can’t run them all.

And, you know, it’s very expensive and sometimes just not practical. So that’s where, you know, again, like yourself, you know, I like to really get to know the patient well and then try to figure out based on my knowledge base, like, okay, you know, I’ve heard this before and these are the tests we should run first.

And then if they don’t yield the results we need, then maybe we’ll look into other things. Right. Yeah. How important is sleep? [00:34:00] Critical. You know, when you look at my books, it’s always the first chapter. Yes. Right. So that’s to me that says it all. Like if I put it at first, that means it’s the most important, at least in my mind.

And yeah, I mean, sleep is when people. Fix things in their body. It’s like when, that’s when things really heal while you’re sleeping. So if you’re not sleeping, you’re not gonna have healing. That’s when you detoxify. That’s when mitochondria make new mitochondria and better ones. That’s when the muscles get stronger.

That’s when the gut cleans things out. It’s you know, without sleep you can’t do all those things. Right. And it’s an epidemic out there. The lack of sleep, absolutely. Epidemic. So what are your

Dr. Weitz: favorite supplements

Dr. Bongiorno: for sleep? Well, you know, when you, when I do the right testing, sometimes we’ll look at to see like, for example, if cortisol levels are very high at night.

And if that’s the case, then I like using herbs like magnolia and amino acids, like fosit sine [00:35:00] theanine can be really helpful to help people to get into that early stage of pres sleep, what they call that alpha state right of sleep. Of course, melatonin. You know, if we can run tests. I like to look at melatonin levels before I start supplementing.

And then there’s, you know, there’s melatonin to help people fall asleep which is regular melatonin. And then there’s time release melatonin, which is better for people who have trouble staying asleep. So, I would say magnesium, of course. Classic. Good choice for sleep too. And then even before the supplements, just making sure the room is nice and dark and it’s cool and people have made their to-do list so they’re not thinking about a lot of things.

And you know, maybe looking into the psychology of why they might be up processing things and talking about that and trying to come up with solutions there. So there’s, yeah, depends.

Dr. Weitz: Right. So let’s go into nutritional supplements for depression and [00:36:00] anxiety. Which

Dr. Bongiorno: ones

Dr. Weitz: Are the first ones you’ll consider?

Dr. Bongiorno: Yeah, so I kind of put them into two camps, even though they kind of intermingle a little bit. There’s this, the supplements I think about to help. Stabilize mood and lower symptoms. And then there’s the ones that kind of work on the underlying issues, which is a much bigger, broader category of supplements.

Right? If you look at for depression, you know, the supplements that have been studied by meta-analysis. So meaning multiple studies, right? Or studies of multiple studies, which ones work at least as well as the SSRIs. So head to head, you take a vitamin, or I mean a supplement or you take the drug ones that work as well as the drugs.

There’s a short list that have actually been studied and I like to think about those. Now, remember what we said before, right? SSRIs work [00:37:00] 25 to 35% of the time, right? So they work but not much better than placebo, right? And I would probably put the supplements in the same camp. Right, right. The only better, the benefit of the supplement is that they’ve also been shown in these meta-analyses not to have side effects that the drugs have.

Right. So. So having said all that I like to think of things like St. John’s Wart, which is classic. But you gotta be a little careful with St. John’s wart. ’cause then it can affect the how other drugs are metabolized. So if people are taking blood pressure medications birth control you know, blood coagulant anticoagulant medications and what they call blood thinners.

You gotta be a little careful with St. John’s work.

Dr. Weitz: And also with patients who are taking SSRIs. And you already said that most of your patients are taking SSRIs.

Dr. Bongiorno: Many of them are you know, one, I think they should work with a skilled practitioner because I don’t think it’s a, it’s an absolute [00:38:00] contraindication.

I just think you have to know how to dose them and start slow. And oftentimes they can be part of the plan to get people off the SSRIs. So, yeah. So then there’s that, there’s Sam ES Adenyl Methionine, right. You know, is also been studied that way. And curcumin has been studied that way. As well.

So Sammy

Dr. Weitz: seems like one of the forgotten supplements.

Dr. Bongiorno: Yeah, absolutely. It’s

Dr. Weitz: not forgotten

Dr. Bongiorno: for me. I kind of think that it was really popular

Dr. Weitz: at one time and I hardly ever hear people talk about it

Dr. Bongiorno: anymore. Well, you know, it’s, I’m so glad you said that because I think that happens in our world. You know, things get popular, they come in and out.

Nobody talks about St. John’s Ward anymore, and it’s brilliant. Right. But I think the issue is. Many of us aren’t thinking about how they work, so they just think about the patient who has depression. Oh, they took this herb St. John’s. It didn’t work. So now I’m not thinking about it anymore. [00:39:00] If you really match it to the person the way an neurologist would, the way a good kind of you know, almost biochemist would, and you figure out, okay, is this the mechanism that they need?

Then you can really, you know, open somebody up with something like that.

Dr. Weitz: Really. But I think the other thing is a lot of times, as we just mentioned, the patient’s already on a medication and you’re worried about using St. John’s war. That might cause a problem with Right. Having too much serotonin. Yeah. I worry

Dr. Bongiorno: less about that because I’m, I’ve been doing this for so long and I understand how the mechanisms of the drugs and how the mechanisms of the supplements work.

Yeah. So I’m a little less concerned about it. Okay. Me personally, I, but I think for those of you listening, you absolutely wanna work with somebody who’s really well versed in these things and don’t try yourself. So will you

Dr. Weitz: sometimes use St. John’s work with a patient on medication?

Dr. Bongiorno: Yes. Yeah, I will.

[00:40:00] But it, it depends on the medication. It depends on other medications that they’re on. Right. You know, ’cause the first thing is make sure they’re safe. Right. So, but yeah, as long as those things line up and it seems right for them then that’s certainly something we’d bring in. Now do you

Dr. Weitz: find that.

A patient who’s getting, you know, a certain amount of benefit from an SSRI or another medication and then they add a St. John’s war, maybe they get a higher level of benefit. Exactly.

Dr. Bongiorno: Right. Is that, you know, it’s interesting. A couple years ago there were some studies that came out about St. John’s War and Plavix.

Right now, and it is generally known that if you’re a blood thinner, right? Yeah. It’s a blood thinner and a clopidogrel and the, and it’s generally known that if you’re on that medication you shouldn’t take St. John’s work ’cause it affects the same liver processing enzymes. Right. Right. So it’ll change how you break it down and people can end up more bleeding and of course that’s very dangerous now.

What the [00:41:00] study showed. Now this was done more controlled with the number of people who are heart patients who had Plavix, but the issue with the Plavix is they couldn’t get the dose high enough because it was giving them too many side effects and people were getting sick with other problems. Right? So what they did was they gave them some St.

John’s wart, and what they found was they got the Plavix to work at the level that was needed at a lower dose, right? So, so, you know, we always think about these things as having negative interactions. Right? Well, the way they can be negative, they can be very positive Right. And helpful. Right. If you know how to use them.

And that’s a perfect example. Exactly. So, so it’s not, it doesn’t mean things are contraindicated. Absolutely. It just means. You know, work with a doctor who knows how to use these things. So Right. This way you get the benefits and not the side effects. Right. And the inter and the negative interactions.

Dr. Weitz: What are some of your other favorite medications? I know Lithium has been getting a lot [00:42:00] of discussion recently.

Dr. Bongiorno: Lithium the nutritional lithium, the supplement. Yes.

Dr. Weitz: Yep.

Dr. Bongiorno: Yeah. So Nutritional lithium, yeah. Recently came out about, it’s, they think about it. Probably is gonna be helpful to prevent things like Alzheimer’s and that literature has been out since actually 2010.

That’s actually not new. But yeah, lithium is a very sup, you know, it’s the. I think people who are hearing about it for the first time should realize this is not lithium, the drug lithium, right. You know, the drug, lithium is a very high dose, very heavy handed. It’s rough on the thyroid, it’s rough on the kidneys.

And and you know, and it comes with another molecule on it that’s, you know, that’s very potent. So that’s the drug Lithium. And that drug is one of the few things proven to lower suicidal ideation. So, and you know, it has its purpose and sometimes it, again, it can be lifesaving, but this is lithium.

The supplement nutritional lithium, [00:43:00] right. Somewhere between five and 20 milligrams instead of the hundreds or maybe a thousand milligrams. Right.

Dr. Weitz: Maybe we should call it LDL. Low dose Lithium.

Dr. Bongiorno: Low dose lithium. Yeah. ’cause that’s what it is. And that’s a great idea. And and you know, and it’s been shown in those small doses, you know, the way in the early 19 hundreds, what they noticed was that the areas around the country where lithium was in the water.  Levels versus areas that had none. People were happier, lower rates of anxiety, virtually no rates of suicide. Crime rates were lower as well in these areas. So, so they started kind of piecing it together, like maybe it’s the lithium, right? And that’s how the interest in lithium started. And so for a lot of us, we don’t get lithium in the water.  With, you know, lithium isn’t in high concentration in too many foods and if people are prone to anxiety and depression and mood issues, it can be [00:44:00] very valuable. I’ve seen it with, in children be very useful. Sometimes I’ll use it with a little broad spectrum. C, b, D, it works really well together for things like impulsivity.

Excuse me. So it’s, I think when used properly, like everything it can really, very valuable to kind of calm that primitive brain and stop some of the signaling that’s going to the cortex, the thought part of the brain that’s making us anxious.

Dr. Weitz: Yeah. What about a few other of your favorite nutrients?  Oh gosh. I love, I know there’s so many. I know. Vitamin, I love Magnolia.

Dr. Bongiorno: Magnolia is a Japanese herb, which is very good to help lower cortisol. Right. I find it can be very helpful for people at night or during the day who have who have a lot of stress and the cortisol levels are very high.

Dr. Weitz: Yeah.

Dr. Bongiorno: Sometimes using that with Sal Serine is very good. I sure can. Ashwagandha again, another beautiful one. And ashwagandha’s nice because it, you know, if cortisol levels are high, [00:45:00] it can bring ’em down. If cortisol levels are low, it could bring them up. It’s good for the hormones too, ashwagandha. So I think about it more when people are having hormonal issues, like let’s say a man with low testosterone and high cortisol, like it’s perfect.

So yeah, ashwagandha is a beautiful herb. Yeah, I mentioned curcumin before. It’s got wonderful anti-inflammatory benefits. Magnesium is classic, you know, I think one that’s not talked about a lot is potassium. Okay. I think potassium is really important, especially when people have more.

Heart related issues and like palpitations and anxiety bringing, you know, and blood pressure issues bringing in potassium can be useful if, the only caveat to that is if people are on potassium sparing medications, they really need to talk to their doctor before adding more potassium ’cause that might not be okay with those drugs.

Dr. Weitz: Saffron is a nutrient that I’ve been hearing more about lately.

Dr. Bongiorno: Yeah, interestingly, so [00:46:00] Saffron I had been working for a number of years for a nutraceutical company about 10 years ago, and I actually formulated one of the first mood formulations with Saffron. Okay. I think it was the first one.  And ’cause I fell in love with Saffron probably like 12, 15 years ago. It’s such a beautiful herb, and it’s even been shown in patients who have both men and women who have sexual side effects from SSRIs to be useful not only for the mood, but for the sexual side effects, then the low libido.  Interesting. So, so yeah, Saffron’s great. Great for the gut. And tastes good in food too. That’s true. And it love Spanish. Right. Nice. Yeah. That color is so beautiful, right? Yeah. That beautiful orange fall. Orange color. Yeah, that’s true.

Dr. Weitz: What about the importance of people being on their phones and being on social media and its effect on depression and anxiety?

[00:47:00] Yeah, I know. I know. We could talk forever just about that topic alone.

Dr. Bongiorno: Gosh. Yeah. You know. I mean, it’s impossible to avoid it. Right? ’cause it’s part of our lives. Right. And there’s no way, I mean, we set this up through screens and Right, of course. And but the issue is some people it affects more than others.

And men and all of us, especially when we’re young, when we have these young brains, when we start getting on these things, it raises dopamine, you know, the lights, the quick moving thing raises dopamine, and then it makes us feel good in the moment. And then when we’re not doing it, we look for it again.

We go, oh, I gotta, you know, you, you know, as soon as if you look. At a public place and somebody’s not doing something, they go right to their phone because we’re kind of looking for the next hit. You know, it’s, it is a drug. Yeah. And for those of us who already have some kind of derangement or dysfunction with neurotransmitters, it’s gonna really feed that.

So, and I do worry about the young people [00:48:00] because their brains are so young and they’re being molded, that taking that drug so often so early is going to change their neurocircuitry and studies are showing that. Yeah. So, so we, you know, it’s very important that we, especially for the young ones that we cultivate.

Their interest in not using them and being outside. You know, one of the things I notice, nature’s very powerful. I notice when kids are at the beach Yeah. They tend not to use their phones and their iPads and things like, they actually play in the water and they still go in the sand. And that’s very gratifying to me to see that, like, even today’s day and age, like the beach is still more powerful than the, I don’t know, maybe it’s the grounding you get at the beach or something.

Dr. Weitz: Well, the power of nature. Yeah. Yeah. So, you know, we have, it’s just to be out in nature and Right. The ocean or being in the forest and, you know, the power of nature.

Dr. Bongiorno: Yeah. So, so the idea is not to say you can’t have this and never use it, but the idea is [00:49:00] to know yourself and know what the balance is for you, and make sure we, you get out and do the other things you need to do, be out in nature and under the sun and, you know, and and then, you know, use your phone as you need to use it too.

Right.

Dr. Weitz: Great. And any other topics that you wanna mention before we close out and then give us maybe a, something to think about?

Dr. Bongiorno: Yeah, I mean, something that I’ve been doing a lot more work in, and I mentioned it earlier, is the vagus nerve and vagal nerve tone. Okay. Like I said, it’s a cranial nerve 10, which is a.

Big nerve that connects the brain right, to not only the gut, but to also the lungs and the heart. And and when we’re really stressed out when our nutrient levels are low, when we don’t get enough sleep, it shuts down. Right? Right. And it shuts down because the body wants to stay in stress mode because it’s gotta fight a bear, you know?

Or run from the bear. Right. And that’s just very it. It raises inflammation in the body. It lowers our [00:50:00] mood. It creates more anxiety. Right. And, you know, and we’re really learning that, first of all. Vagal tone plays an important role in not only mental health. Like I, I just did a dis a talk in in actually in Hong Hong Kong, in Thailand, in Bangkok on okay.

Vagal nerve tone and PTSD, post-traumatic stress disorder. And that talk really really focused in on, on how patients are post-traumatic stress disorder. You know, less than one third of the treatments work for post-traumatic stress disorder. And that is very much is a vagal nerve tone issue.

And that there are ways in patients to measure vagal tone, like using heart rate looking how the pupils work, looking at how digestion works. So there’s a lot of different ways you can assess vagal tone. And then there are ways to actually work on it. You know, there are ways [00:51:00] using meditation, using yoga, using vocalization singing.

There’s ways using vagal nerve stimulation, either from the ear or from this area specifically. They even have studies. In PTSD patients now using what they call invasive vagal tone stimulation, where they actually implant something that goes directly to the nerve. Wow. I don’t think most people need that, honestly.

And that’s not my first preference. Right. I think there are plenty of other ways to do it. And it’s also been shown that when you get things like vitamin D and at the right levels and magnesium and you lower metal toxicity, that you can also support. How the vagal nerve works too. So there’s a lot of ways, a lot of holistic ways to get the gut right, to get the vagus nerve working to, you know, to detoxify, to get the vagus.

And so I kind of feel it’s a really important center point of why we do everything we do, you know? So very exciting

Dr. Weitz: And of course in the gut plays such a big role [00:52:00] in brain function. As you mentioned, the vagal nerve. We have the fact that in the gut, the majority of neurotransmitters are produced.

Dr. Bongiorno: Right, exactly. So it’s it’s a really, you know, good place. I mean, there’s so many ways you can look at mood, and I think that’s a good way to look. One of the important ways to look at how to help a patient is by supporting that system. Right. Great.

Dr. Weitz: Okay. Any other final thoughts and then give us your contact information?

Dr. Bongiorno: Yeah, no, I mean, I would say if anyone’s listening and you know, and you feel that you know, you’re just, whatever it is you’re working with and maybe suffering with you feel like, well, it’s just never gonna go away, just know. That there is always a way to figure things out. You know, there’s always someone who cares and is looking to help.

And it might not be one person, it might be a couple of people as a team, you know, and maybe you can’t do everything at once, but as long as, you know, you work [00:53:00] with people who are organized and you find that, you know, you connect with them in the way you need to be connected with, which is of course different for everybody that you can organize.

What needs to be organized and find the help you’re looking for. So just keep looking. Don’t give up. You know, the body is speaking and it’s trying, you know, it’s trying to talk to us so we can come up with the right solution. So just don’t give up on that. Great. How can patients get in contact with you?

Oh, sure. My phone number for those who still call on the phone, which I prefer is 9 2 9. 3 7 9 0 9 2 7. And my website is dr peter bonjourno.com, so that’s D as in David, R as in Richard, Peter Bonjourno. For those who are on Italian, it’s B-O-N-G-I-O-R-N o.com. That’s great, and thank you so much, Peter.

Oh my gosh, what a pleasure. And thank you for [00:54:00] everything you do and for spreading the good word and just being such a source of light for people. That’s great. I appreciate that.

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star readings and review.  As you may know. I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity. Please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.