Book Review: Brain Energy by Christopher M. Palmer, MD
Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health – and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More, by Christopher M, Palmer, MD
Published: 2022, Dallas, Benbella Books, Inc.
I must admit to a certain amount of trepidation when I pre-ordered this book a few months ago. I’m interested in the role of human nutrition and metabolism in what we currently think of as diagnosable disease. However, the thought of parsing through the terminology associated with mental health and even more cell biochemistry was truly daunting. I should have calmed my beating heart. Chris Palmer has written an excellent book in which he does a fabulous job of explaining complex medical issues in layman’s terms.
Like so many, including me, who have drawn a connection between human metabolism and chronic disease, Dr. Palmer started unexpectedly. In 2016 he recommended the ketogenic (very low carbohydrate content) diet for a patient who had been on prescribed medication to treat serious mental illness for 20 years and needed to lost weight. After only a couple of weeks on the diet Dr. Palmer noted that his patient’s clinical symptoms began to improve. Within six to eight weeks his patient was exhibiting fewer hallucinations and delusions and started to live a more normal life. At the end of the diet, his patient had lost 160 pounds and his mental illness was in remission. Dr. Palmer decided to investigate and what he found changed everything that he had been told in his medical education.
“Chris Palmer has written an excellent book in which he does a fabulous job of explaining complex medical issues in layman’s terms.”
Conventionally, biochemical imbalance has been seen as the cause of mental illness. This view has prevailed even though greater than 50% of people suffering from mental illness are not improving on pharmaceutical drug therapy. The incidence of mental illness is increasing, and it is now the leading cause of disability, greater than cardiovascular disease. Dr. Palmer does make the point that many pharmaceutical drug and psychotherapies can help some patients, especially in the short-term, but for the most part they do not work. The field suffers from not understanding the root causes of various illnesses or what to do to cure them.
Early in his research, Dr. Palmer was impressed by the century-old use of the ketogenic diet to reduce and stop the incidence of seizures in patients suffering from epilepsy. He noted the evidence for the diet having a positive effect on epileptic patient neurotransmission, chronic inflammation, gut microbiome, and even gene expression. This led to him conducting a deep dive into the potential for a nutritional and metabolic link to mental illness.
Dr. Palmer describes the 200 years of research available in the public domain. For example, it has been known since the nineteenth century that people suffering from mental disorders were also diagnosed as having Type 2 diabetes mellitus (T2D) and vice versa. In the twentieth century, links between metabolic disorders and autism were established. Since the start of the twenty first century much research has been done into Parkinson’s and Alzheimer’s disease and shown a link to metabolic dysfunction. Within the evidence, Dr. Palmer noted a significant overlap between mental disorders and other diseases suspected of being caused by metabolic dysfunction, such as cardiovascular disease (CVD), T2D, and obesity. Controversially, Dr. Palmer notes that some current medical treatments may make worse the incidence and severity of CVD, T2D, and obesity. For the first time, Dr. Palmer has assimilated and drawn conclusions from all the pieces of the puzzle under a single coherent hypothesis.
Dr. Palmer emphasizes that there may be more than one route to metabolic dysfunction in the brain, including insulin resistance, hormonal imbalance, vitamin deficiency, stress, and gut microbiome alteration. However, he concludes that, irrespective of the starting point, brain cell mitochondrial dysfunction is the common root cause of mental illnesses including depression, anxiety, bipolar disorder, schizophrenia, and neurodegenerative diseases such as Parkinson’s and Alzheimer’s.
“Mitochondrial function affects every cell in the human body through their involvement in all aspects of cell function, neurotransmitters, hormones, inflammation, immune system function, regulation of gene expression, development, and the maintenance and health of cells.”
This book greatly updated my outdated view of mitochondria as simply producers of cellular energy. Mitochondrial function affects every cell in the human body through their involvement in all aspects of cell function, neurotransmitters, hormones, inflammation, immune system function, regulation of gene expression, development, and the maintenance and health of cells. Mitochondria are the only organelles that move around cells to where they are most needed and when. They interact with each other and with the other organelles.
Dr. Palmer uses analogies in support of his hypothesis. One of my favorites is that mitochondria move around the cell and use all other organelles as machines like super-workers in a factory. Why might mitochondria have evolved to be so powerful? They were the first organelles in our cells and were at one time an independent living bacterium. As he says, “They are the drivers of cells and metabolism. They are the workforce of the human body.”
Dr. Palmer devotes about half of his book to “Causes and Solutions”. He describes treatment solutions within a framework of principles that include:
Existing treatments - a new theory doesn’t replace the things we know already work
Removal or reduction of mitochondrial dysfunction - poor nutrition, sleep disturbance, substance abuse, some medications, and sources of stress
Correction of things like hormone or neurotransmitter imbalance
Metabolic improvement – more mitochondria, fewer defective mitochondria, fewer defective cells
One of the chapters dedicated to contributing causes of mental illness is entitled “Food, Fasting, and Your Gut. In it he states “…there is no question that the gut microbiome plays a role in mental and metabolic health.” However, he cautions on multiple occasions that the microbiome field is still very much in its infancy and that certain medical interventions are still very much still experimental.
“…there is no question that the gut microbiome plays a role in mental and metabolic health.”
There is real potential to turn diseases like schizophrenia and bipolar disorder from the life-long disabilities that they currently represent into treatable conditions that may be fully resolved. Indeed, Dr. Palmer points to case studies in which this is demonstrably true. My personal favourite is the story of Mildred, a seventy-year-old obese schizophrenic patient. Her doctor advised the ketogenic diet for weight loss and after just two weeks she began to lose weight and noticed an improvement in her psychotic symptoms. Now, thirteen years later, she has learned how to take care of herself, is 150 pounds lighter, symptom-free, and not taking her old medications.
Mildred shows us that it’s never too late in life to make a positive change. Repeating her level of success will require that the medical profession integrate a view of individual symptoms and treat their patients as a whole person suffering from a form of mitochondrial dysfunction.
If you are interested in mental health and how it relates to things like nutrition, read this book.
About the author
Dr. Chris Palmer is the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School. For over 27 years, he has administrative, educational, research, and clinical roles in psychiatry.
Recent podcasts with Dr. Palmer discussing his book
Revolution Health Radio
The Link Between Metabolism and Mental Health, with Dr. Christopher Palmer - https://chriskresser.com/the-link-between-metabolism-and-mental-health-with-dr-christopher-palmer/
Huberman Lab
Dr. Chris Palmer: Diet & Nutrition for Mental Health https://hubermanlab.com/dr-chris-palmer-diet-nutrition-for-mental-health/