Dr Sanjeev Sharma: A Philosophy for Life

This week on the podcast we're going to discuss mental health. I know we're going through a pandemic, and mental health is a major problem even before the pandemic came along, and has certainly thrown some challenges to us from a mental health perspective.

My guest today is a Consultant Psychiatrist, Dr Sanjeev Sharma. He has an interest in General Adult Psychiatry. He specialises in Psychotic illnesses, Bipolar Disorder, Anxiety, Depression, ADHD, Addictive Disorders, and Transcultural Psychiatry. He regularly lectures for the Australasian College of Nutritional and Environmental Medicine.

I think you will find Sanjeev's philosophical approach to health and mental health, a very big part of that, is a really inspiring one. I hope you enjoy this conversation I had with Sanjeev.

Health Podcast Highlights

Dr Sanjeev Sharma: A Philosophy for Life Introduction

Well, mental health. I know we are going through a pandemic of some of the Coronavirus, but mental health is a major problem even before the pandemic came along and has certainly thrown some challenges to us from a mental health perspective. I’ve often said on this podcast that I prefer, I’m always preferring to see the cup as half full. This is an opportunity for global reflection for us to stop and pause and consider what is really important in life and reflect on it. Also an opportunity to reflect on health like never before.

The biggest defence of any disease, including the current pandemic, is a healthy immune system, and when it comes to mental health, a healthy immune system is an important part of that. So today my guest is a Consultant Psychiatrist, Dr Sanjeev Sharma. He has an interest in General Adult Psychiatry. He specialises in Psychotic illnesses, Bipolar Disorder, Anxiety, Depression, ADHD, Addictive Disorders, and Transcultural Psychiatry.

I think you will find Sanjeev’s philosophical approach to health and mental health, a very big part of that, is a really inspiring one. He also has a Masters in Nutritional Medicine. I think a very important thing for anybody dealing with mental health to have, and it’s a theme we’re going to be exploring a lot more in the coming weeks. And he regularly lectures for the Australasian College of Nutritional and Environmental Medicine. I hope you enjoy this conversation I had with Dr Sanjeev Sharma.

Podcast Transcript

Dr Ron Ehrlich: [00:00:01] I’d like to acknowledge the traditional owners of the land on which I am recording this podcast, the Gadigal people of the Eora Nation and pay my respects to their elders past, present and emerging.

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Well, mental health. I know we are going through a pandemic of some of the Coronavirus, but mental health is a major problem even before the pandemic came along and has certainly thrown some challenges to us from a mental health perspective. 

I’ve often said on this podcast that I prefer, I’m always preferring to see the cup as half full. This is an opportunity for global reflection for us to stop and pause and consider what is really important in life and reflect on it. Also an opportunity to reflect on health like never before.

Dr Ron Ehrlich: [00:00:58] The biggest defence of any disease, including the current pandemic, is a healthy immune system, and when it comes to mental health, a healthy immune system is an important part of that. So today my guest is a Consultant Psychiatrist, Dr Sanjeev Sharma. He has an interest in General Adult Psychiatry. He specialises in Psychotic illnesses, Bipolar Disorder, Anxiety, Depression, ADHD, Addictive Disorders, and Transcultural Psychiatry. 

I think you will find Sanjeev’s philosophical approach to health and mental health, a very big part of that, is a really inspiring one. He also has a Masters in Nutritional Medicine. I think a very important thing for anybody dealing with mental health to have, and it’s a theme we’re going to be exploring a lot more in the coming weeks. And he regularly lectures for the Australasian College of Nutritional and Environmental Medicine. I hope you enjoy this conversation I had with Dr Sanjeev Sharma. Welcome to the show, Sanjeev.

Dr Sanjeev Sharma: [00:02:08] Thank you.

Dr Sanjeev Sharma’s Professional Journey 

Dr Ron Ehrlich: [00:02:09] Sanjeev, you are and you are a psychiatrist, but your journey is not typical for a psychiatrist. Well, not yet anyway. I think it is the way of the future. I wondered if you might just share with us your journey through medicine and how you’ve reached this point in your career. 

Dr Sanjeev Sharma: [00:02:28] That’s a very interesting point. All of this started like I always had a soft corner for lifestyle interventions and medicines, and usually, it comes on from upbringing from an Eastern world where a lot of grandmother’s recipes have been used for a lot of ailments.

I can historically recall Mom was very keen on that what kind of foods we should combine and what not and when to eat. And so there is a Hindi word for it, it is called […]. So which means that it is not good, so if you are eating a particular food, then it is also not good [… ] means it can have an impact on your decisions and other things.

Dr Sanjeev Sharma: [00:03:14] In the last four to five years, when I was coming through roadblocks after becoming a psychiatrist where you see certain patients, you see that like, “Why they are not responding? Why, why is a natural like a relapse happen if there is no culprit or what makes an individual vulnerable?” 

So I came to know about, one of the giants in Neuropsychopharmacology, Dr Stephen Stahl, who has been practising in the field of psychiatry, would have read his books and his work is a psychopharmacologist and one of his annual conferences there was a discussion around Vitamin D and its neuropsychiatric manifestation.

Dr Ron Ehrlich: [00:04:02] Wow. Okay. Well, hang on now. Stop because Stephen, say that against Stephen…?

Dr Sanjeev Sharma: [00:04:08] Stephen Stahl.

Dr Ron Ehrlich: [00:04:08] Stahl.

Dr Sanjeev Sharma: [00:04:10] S-T-H-A-L.

Dr Ron Ehrlich: [00:04:14] OK, so Vitamin D because Vitamin D should be getting a lot more, you know, attention in this pandemic. But here we are.

Dr Sanjeev Sharma: [00:04:24] Yes.

Dr Ron Ehrlich: [00:04:24] Go on. This is a, I knew I would enjoy talking to Sanjeev. 

Dr Sanjeev Sharma: [00:04:29] Yes, yes. So Vitamin D and Neuro-Psychiatric manifest each other. It was a real eye-opener for me. OK? And when I went through the literature and then subsequently, I did my own hand that how Vitamin D works, then I heard about the normal ranges. Okay. And there is a lot of confusion around it. 

And I think if I’m not wrong, I think a professor, he’s an endocrinologist who has worked in this area and criticised a lot of standard guidelines where which was mainly designed to prevent rickets. From that, I came to know that when Vitamin D is acting, there are certain core factors which are needed. 

And through one of my colleagues who is now retired, I came to know about micronutrients, that and its role in mental health. And he used to ask people to take some vitamins or some healthy nutrients, which was obviously there because mental health patients have poor food habits. 

Dr Sanjeev Sharma: [00:05:35] Later on, when I came across certain local practitioners and one of my very highly regarded mentors, Dr. Igor Tabrizian, I read his books and came to know the world of where we are. And then to that, I came to know about ACNEM and then the journey started. So you can see that there it was like a cry, which was, I think, long-awaited, possibly from my younger days.

ACNEM explained

Dr Ron Ehrlich: [00:06:03] Now for our listeners, Sanjeev, for our listeners who may not be familiar with that acronym, ACNEM, you know, we are talking about the Australasian College of Nutritional and Environmental Medicine, of which we are both members of. Yes, and a terrific organisation.

Dr Sanjeev Sharma: [00:06:20] And first I looked into the online, the webinars, which was there and then took a membership and then subsequently attended conferences. And later on, I had a chance to attend and meet Dr. Walsh through bio balance and attend some of the dedicated workshops on mental health. It opened up certain channels and since I was very hungry for knowledge and this is where I think I tell all my patients that when a doctor says there is nothing more can be done, doesn’t mean you have to stop. 

And usually, parents or family members don’t stop, even if they are told that no, there’s not much hope. And time has proven that a lot of times family members themselves have gone well beyond, and some of these holistic moments have started and have seen amazing work done by the dedicated family members.

Dr Sanjeev Sharma: [00:07:16] So and then once I came to know about that there are several like holistic factors are needed in the manifestation of these disorders, which are obviously there is no single gene which has been found and then came to know about certain courses about epigenetics, understanding them and understanding about that functioning various districts. Overall, it’s still a student and I’m journey and I’m sure this will be a long tail end of my life. So… 

Practitioner & Patient relationships explored

Dr Ron Ehrlich: [00:07:58] It’s an interesting point, though, and I think it’s worth for us both as health practitioners to reflect on it from a patient’s perspective, because so often, so often people are complaining of something, and pain is a good example. 

But they’re in chronic pain and they’ll have X-rays, blood tests, CAT scans, MRI’s, you name it. They’ll have everything, and the doctor will turn around to them and say, “Mrs Smith, Mr Smith, there is nothing wrong with you.” And whereas the practitioner, if they were really being honest, should say, “Mrs Smith, you know what? I really don’t know what’s wrong with you.

I think we need to find out more.” But of course, egos play a very big part in health practitioners lives for various reasons, but it’s so lovely to hear of you as a psychiatrist to be so open to this. And I know that you mentioned to me when we were talking recently that you try to impart on your patients this idea that it’s a philosophy of life rather than a… Go on. Tell us about that because I thought that was brilliant, that was a really important concept.

Dr Sanjeev Sharma’s Philosophy of Life

Dr Sanjeev Sharma: [00:09:11] And it is a very important point, Ron, because sometimes often I’m asked how long I’m supposed to take this because usually, that’s what we go. We think that it’s a there’s something, there’s something wrong with us. We have gone to a doctor, we have paid him a fees and he gives us a script like medication. And sometimes there was dietary advice are also like a script. And then the next question is how long you are supposed to take it for.

So this is where I think it is important for many listeners that sometimes some of these ailments like have developed over the period of time, and it actually could have started at the time of the creation of an individual.

 So when that zygote was formed, OK, what was the ecology of the genetic vulnerabilities which was given to that individual and then later on during the course of development in the foetus, what kind of exposures were there, particularly if there were toxins or deficiencies, then you create a lifelong challenge for that vulnerability to be there. 

And when it meets with certain catastrophic events, either because of their lifestyle choices like substance use or major trauma or some infections like the way we are seeing now are the treatments associated. Then you, you a person becomes vulnerable.

Dr Sanjeev Sharma: [00:10:43] So my goal is always that, “Hey, you have to keep it in mind that you have to change the way you eat till you are in this body because if you are going to do weird, the body is not going to be harsh on you straight away, it will tell you signals.” OK, so these signals are like itchiness, congestion, bloating, burping constipation, tiredness. 

And I often got examples, my own personal examples, and I often share that like, unfortunately, like I can tell my personal story, I lost my dad in his early 30s. He died. We don’t know what was the cause, but he died suddenly and possibly it wasn’t MI. So which means that there’s a risk factor in my family that I’m prone to have an illness.

Myocardial Infraction

Dr Ron Ehrlich: [00:11:43] Now, MI Sanjeev is Myocardial Infarction?

Dr Sanjeev Sharma: [00:11:50] Yeah. So, which means that I have to ensure that what I’m going to eat, which could prevent this from happening. So certainly, certainly diet and lifestyle factors plays a very big role in any cardiovascular illness, including our diseases and other illnesses as well.

So, then I came to Australia, there were certain foods which was introduced to myself, which I didn’t knew so you can have sort of European cuisines in a box. So I used to like croissants, very much, OK, and I’ve noticed and this is a very, this is only I could now date back and unlearn when I look back, I and I used to have… After eating croissants, I would feel tired. OK. And sometimes we don’t even realise that eating food will (make us) tired, but now we have learnt from the nutritional assessment, that’s a sign of insulin resistance.

Dr Sanjeev Sharma: [00:12:56] That’s a sign that you are intolerant to this food partly saying, “Please lie down, and after one, one and half hours, you could feel fresh because by the time that the digestion of that food would have processed.” So if people start understanding the signals given by their body, then they are much more receptive to what they and they should not do. And that clarity comes up. We all know that, OK, we can do allergic testing. We can do all advanced panels of testing, but using elimination techniques to fix your diet is a very simple way that goes food.

And this is where I was coming back to my olden days of my growing up and combinations of the food were so, not used and why? So like, for example, in aromatic cooking, first, a plant-based diet is promoted. That’s the whole philosophy comes from that. And these are Sanskrit word used “Satvic.” S-A-T-V-I-C. 

And the primary reason for that Satvik philosophy or do it diet is that first, human beings have got a large intestine. OK? And when we have a large intestine, the food has to go through a long time and meat-based eating and have a small intestine. And the way we are designed and we are small, well-proven that inflammatory diet mainly is plant-based, sorry animal-based diets. 

But when we are switching on to the plant-based diet and the anti-inflammatory process comes the same source like it could be a protein. But if the same protein is animal-based, it will be more inflammatory as compared to.

Dr Sanjeev Sharma: [00:14:51] So and I remember there are certain traditions which have been used wherein Indian cooking that are lot of the way cooking is done in order to make a protein more bioavailable. There are certain treatments done to a grain. So certainly when you are cooking a doll, you actually soak it. 

Some of them are soaked even overnight, like chickpeas, actually. And what you do is, you know that it activates the juices, the fatty acid, and as a result, bioavailability of the nutrient is available. And then whenever you have to eat any certain foods, particularly when you are eating a masala, we use the word masala, which is actually comes from Sanskrit. 

So and a garam masala, garam means hot. That’s a very, and masala is the collection of herbs, which is used, now, masala itself is a combo of 18 to 20 different herbs. When you put a teaspoon into your cooking, and I remember Jason had a lock with one of the gurus in the area that held a…

Dr Ron Ehrlich: [00:16:09] Yes, and we’ve spoken, we’ve spoken to Jason about the microbiome from the University of Tasmania. Jason is a legend. It’s true.

Dr Sanjeev Sharma: [00:16:18] And if you, I don’t know whether he talked about it, but he had a gainful workshop in Perth, he told that he went to Sri Lanka once and he first came to know that there are several types of bananas in the country. OK? There was none, and each banana tastes different. So from a food perspective, these are all different foods.

Now, he also said, clearly, remember that we should have a biodiversity of food, and biodiversity comes when we have different ingredients of the food. So let’s say if we have eaten a masala in your curry or whatever you are preparing. 

You have already created that environment that he said, I think a set about up to 30 or 40 different foods. So if you have already created for the discussion of garam masala, you have added a very tiny dose of a particular food and then gradually.

Dr Sanjeev Sharma: [00:17:15] So this is where I think if we come from my eastern roots, I would say it came up that how the diversity of the food, the season of the food, OK, what time to cook, how to cook, and another thing if it’s at a higher level, what is the emotion of the person who is cooking. It is very, very considered that if you are going to, you may not damage anyone, but with your emotions sometimes, negative emotions, you can damage the environment that we talked about. And that’s where the high level of feeling comes.

OK, so the true definition of health does include higher levels, which include spiritualism as well. So these are when any kind of work or healing is done but this holism attitude. It makes a huge difference. And I have seen that people have remarkable responses. 

And there are few people in my books and I have told them that I don’t see them anymore, but I told them that like if you would have not been dead and you would have not tried some of these things in you, chances are I would have not been doing because you gave me a chance to work with you. And I never could take credit because, you know, we always are given credit for some good work. I said, no, I would just, I would say, a tugboat of the last ship.

Dr Ron Ehrlich: [00:18:50] Nice, smooth. Nicely put. Nicely put.

Dr Sanjeev Sharma: [00:18:53] And you were the captain. You were the captain. OK? We were just a tugboat. If you would have not cooperated in this journey, we would have not succeeded. It doesn’t. It’s not that you come in. And so this is where the food philosophy comes in. So whenever I do take a history of their diet, what they eat and ask them, do you think that they are willing to change because, you know, sometimes people can be a bit sceptic, which is not a problem, OK? 

And as we discussed with you, like if we have very standard resource folders or research documentaries, books and other things are there, which is a positive part in this part of the now, the time where we are living, it resonates with some of them. 

And these are very famous, I would say the interventional paradigm from addiction, medicine, brief interventions is better than doing nothing. If you see someone and say that, OK, these are your problems, OK, and you must spend, this looks like this is going on. And if you don’t change, chances are you are marching towards your health. OK.

Dr Sanjeev Sharma: [00:20:14] So whenever and I can, I saw a young man yesterday, his blood sugars were completely fine, but his insulin levels were around I think I’m not wrong early 30s and I told him, I’m sorry to say, but you are marching towards Type 2 Diabetes and this is a journey. 

A chronic illness, including mental health and physical health, is a dish which you need to cook. And it’s a combination of factors with the vulnerable genetics and environment that eventually one day will precipitate.

Dr Sanjeev Sharma: [00:20:53] OK, so but the important part is that if you take the journey of your well-being, you can always reverse it, okay. And when you are taking health as an investment from an economic point of view, OK, and take insurance where you take dietary investment because that’s an investment sometimes supplements, including you are taking an insurance premium and importance of insurance only comes when you have to claim it. 

Prior to that, it’s a liability. OK. And I’ve said I often talk about that an average Australian owns about 20 to twenty five dollars in that. That’s an average salary. But if you realise importance that, yes, this is going to be helpful for me, I’m reasonably confident you will find the ways to fund it. 

And if out of eight hours of your work or seven hours if your work, if one hour of your salary goes towards your health and the rest of it for anything else, chances are you will be able to do it because nobody’s going to come and teach you.

Dr Sanjeev Sharma: [00:22:04] So I think we all firstly think that working in the area of integrated health should be spending that much time with the family. And I always invite if these are family members to come along with the person to either give me a collateral history or they listen as well what I’m saying, and often that can happen, that some brief suggestions are given to them as well. 

Like, for example, a mother comes back for herself and the child has a similar problem like and often see ADHD in that area where the child has been investigated mother comes for their treatment and I tell that, OK. This is things sometimes may not be spoken about, but just read the work of Dr James Greenblatt and read the book Finally Focussed. 

He’s a child psychiatrist. And how, what is a main I think I’m looking forward to Dr Rucklidge stock because she has been a very big proponent of its holistic strategies on ADHD. 

Diseases as Mitochondrial Dysfunction

Dr Ron Ehrlich: [00:23:08] So it’s interesting, isn’t it? You mentioned Vitamin D and other cofactors, and this is all not new to us, really, because we all studied it in undergraduate dentistry, medicine, you know, undergraduate science. We studied biochemistry. But unfortunately, it was a subject that all we had to do was pass it in the second year and once we passed it, which we didn’t have to worry about it anymore, thank goodness I passed by chemistry. I never have to do it anymore. 

And yet every cell in our body is doing it every day of our lives for us and our patients. You know, the other thing that I thought was great when I spoke to you the other day and I wanted you to share this with us as well, that any disease is mitochondrial dysfunction. And what did you mean by that? I think you better give us, remembering this is not a medical audience. Give us a Mitochondria 101 and tell us why mitochondrial dysfunction is central to so much disease 

Dr Sanjeev Sharma: [00:24:08] Those who are listening. But I’m sure a lot of you have would have heard about mitochondria. So mitochondria is, from the evolutionary perspective, is not part of us. It’s a bacteria which has come inside and it’s like a refugee who came and he has been given citizenship to the country. 

So and he promises that till the end of our life, he’s going to work and help us by giving us vibrancy. So what happens is that and we all know that we talk about fuel-efficient vehicles. Nowadays, we want fuel efficiency and now like fuels are available. When you go to a filling station are batteries and cars and everything is coming up. 

Now in order to have a very fuel-efficient body or a healthy body, we need fuel-efficient mitochondria, which means that the powerhouse of our engine should be robust enough that it can function.

Dr Sanjeev Sharma: [00:25:12] So as you know, when we go for our servicing of our car, we are given a certain mileage that after that we should go back to service. That doesn’t mean that after a single kilometre after that, it would stop working.

 But if we don’t keep them on watch, then gradually over the period of time, one day we will be stuck on the middle of the road and we have to call. So whenever we are struggling with our health, usually if the mitochondria which eventually bears the brunt because it has to, it has to sustain you for your health and your life.

Dr Sanjeev Sharma: [00:25:54] Now, through this journey of my, my reading and on my various training programmes that have undergoing I came to know that we generate equal to our weight of energy every day. So like, if you are 50 kilos, 60, 70, we generate 70 kilos of energy every day and that can only happen if we have healthy mitochondria. So and lots of medications, which we do use have got an impact on our mitochondrial functioning. 

And the classic example is statins, OK when we take statins and by standard guidelines do not recommend to take certain cofactors when people are required to take statins that I don’t know. But we all know that it has an impact on coenzyme Q10, which is one of the, I would say, intimately like roles in proper functioning of mitochondria.

Dr Sanjeev Sharma: [00:26:49] So what happens is that when we make up with changes in our lifestyle choice, which means that we add bad foods or we have a lack of Unstress and then certain environmental factors, which include exposure to toxins like heavy metals, which can be from birth or which can be over the course of time. 

All of this can have an impact on the mitochondria. So gradually what happens is that mitochondria start to struggle and then gradually it can start to burst. Like which burst means that inefficiency. And when it is inefficient, then it cannot clear the toxins out of your body. And when it cannot clear the toxins of your body, and as a result, we suffer and that give rise to for autoimmune diseases.

Dr Sanjeev Sharma: [00:27:48] So and if we start reverting back, looking to the various, so when we take a look at the mechanic, it looks into and tells us what other needs to be fixing. And so then we are trying to fix the mitochondria. We are trying to fix the core process through which it operates. 

OK, so. Just to give an example to the viewers, that in a cancer cell, it’s like the car, which has never been serviced and it is a very cancer cell majority of them are very energy-hungry glucose, but then inefficient that is there is not what we call it the Krebs Cycle pathway only survives on a glycolytic pathway. 

That’s just the terminology, which means that it uses a lot of glucose to solve us and alkaline environment is detrimental to the survival of a cancer cell. And this was the statement given by Otto Warburg in 1931, a Nobel Laureate who was a big proponent of this.

Fish oil benefits reel

Dr Sanjeev Sharma: [00:29:00] So when we are making changes to our dietary choices that we are cleaning the diet and introducing healthy fats into the system, we create an environment where we promote the health of our mitochondria. So. So a lot of you would have heard that in order to prevent a heart disease or something diabetes, you should use fish oil, and I’m sure all of you are buying fish oil. So what actually fish oil is doing? 

So fish oil is basically a like keldy less of the outer ring of the mitochondria. We call it phospholipids. OK, it’s like insulating the house. OK, so once we have healthy or good quality insulation, then it won’t leak. OK, so so this is where the dietary factors plays a role. And then when you get rid of the culprits, which are the dietary choices and then removing the toxins from our body. And the chances are we treat the health of this struggling mitochondria.

What happens when you fast for 14 hours

Dr Sanjeev Sharma: [00:30:11] Now, as we talked about that when we are, how we can generally improve mitochondria health and this is something I have been practising and I’m sure all of you some of you would have heard about intermittent fasting. Hmm. OK. 

So what happens is that when we start fasting beyond 14 hours, the internal mechanism kicks in, it’s like a paralytic system in an oven when it kicks in and it just cleans up the dirt and including those mitochondria, which are of the cells, are enduring the mitochondria, which are damaged at the heart of our immune system. 

And we it leads to our health. So and if we all know we clear the cobwebs or clean the house every day, chances are there will be no dirt in the house. So that’s why fasting is very much recommended and should be part of our life. And when we do fasting, what we are doing is we are trying to retrieve mitochondria, OK?

Dr Sanjeev Sharma: [00:31:22] And diet plays a very important role in that. Now, the forebrain is very vulnerable. OK, let’s say Mother Nature gives lot number of cleaners to the particular cells. OK, now the amount of mitochondria given to the brain cells is much less than as compared to kidneys, our heart, and lungs and other body parts. OK. 

And so as a result, whenever there is a brain insult, it is even more important that we need to take care of the mitochondria because chances are we have got less number of soldiers are the people to work for us. And this is where we, degenerative disorders exponentially can go downhill backwards and can go downhill if the care is not given. 

And usually, the trajectory in a classical case could be anywhere between a few months to sometimes it can be a few years, but never that it goes on beyond a decade, seven, eight years, once a person is diagnosed, they usually die OK. And it’s not a good death in that way because you see them suffering. So if you want to take your charge of your health, chances are to start looking into the health of these soldiers because if you take care of them, chances are they will always give you back. 

What is Smart Pharmacology

Dr Ron Ehrlich: [00:32:50] Now, another term that I heard you use when we were talking was smart pharmacology because mental health is often associated with medication. It’s the go to, you know, someone walks into practise, you know, with depression or anxiety. Often they will leave the practise with a prescription, a medication of some sort.

Tell me about, but I love your term smart pharmacology and the dosages in which you’re using it, which is part of that. Tell us what smart pharmacology means.

Dr Sanjeev Sharma: [00:33:30] Well, what it means is that like there’s often a term used in any treatment is treatment assistance, that we have started treatment. So let’s say a person comes in with a history of depression. There’s a very likely chance that it could be a spontaneous recovery can happen. And if that happens, that’s fine. 

These are subgroup when they are depressed, if they are given a medication like 33%, about 30% will improve by the single intervention. And then you have to add another medication. So the majority of the medications in the psychotropic, if you call them in broad like both antidepressants which stabilises.

Dr Sanjeev Sharma: [00:34:20] First, they are reuptake inhibitors. So what happens is that some that are theories around that people with depression could have low amount of serotonin or low amount of dopamine, or these are the neurotransmitters which are that are lacking gabba. So when we use the word smart pharmacology, what I mean is that whenever a person is taking a medication, usually it results in preventing the uptake of that neurochemical. 

OK, so like serotonin, if you are taking an SSRI, which is a Selective Serotonin Reuptake Inhibitor, which means it will prevent that particles prevent it so in simple terms, it turns out the pump after serotonin uptake. As a result, a particle is created and you should feel better. 

Dr Sanjeev Sharma: [00:35:19] Now what about if we are keep on pumping up, but we there is no water because these medications don’t make serotonin, and they only will trap if it is coming on… OK, so my classic, when I’m explaining to someone, a majority of them basically saying that I give the analogy of a dam wall that when we make a dam wall, we expect there is more water on the direction of the flow of the river. 

  1. So dam wall is like medicine. OK, but does dam wall make water? No. It has to rain. It has to come from a source, added a natural sort of melting glacier aura aquifer where it is sourced is coming from otherwise. So if we start to create an environment where we can enhance the production of neurotransmitters like serotonin, like dopamine which is so and these are neurotransmitters are outcome of proteins. OK. 

So when we eat proteins based on cofactors, it broken down into its constituent and depending on the need, these we get the serotonin so. 

Dr Sanjeev Sharma: [00:36:32] So like, for example, serotonin is because it is five HDP, five hydroxytryptophans, which comes from tryptophan, which comes so as dopamine precursor is phenylalanine tyrocine. So these are again amino acids. So if a person is, there’s a net reduction in their protein intake in their diet. 

And that doesn’t mean, as I mentioned earlier, it has to be predominantly meat-based. OK. People may choose to eat meat, but again, it should be prepared in such a way that the Prall Index, which is potentially […] of that meal, could be more on the alkaline side gig. 

Dr Sanjeev Sharma: [00:37:14] And this is where my another interest comes in. That’s why plant-based are important because majority of our enzymes work at the beheaded of 6.8 to 7.2. But those who like love gardening are farmers would know importance of edge of the soil. So edge the soil is very important for growth of any crop that you are using.

 And so as other neurones, so neurones are like tiny plants, so they like to have a favourable environment or a soup in which they are growing and also the fertilisation and nutrients. So if we start to give some of these cofactors and there are advanced panels of testings which are done which are not covered by Medicare to be honest, but that you can get some idea based on the basic panels, you can start integrating these foods, which are going to make that neurotransmitter. 

And as a result of that, when you already have enough fuel in your system, chances are people can recover if they have. But even if you are using the medication, then you don’t require a higher dose of medication.

Dr Ron Ehrlich: [00:38:28] You don’t need to. We don’t need to build the dam wall so high if there is any water behind that.

Dr Sanjeev Sharma: [00:38:36] That’s true. That’s good.

Dr Ron Ehrlich: [00:38:37] Also would make it, which also would make it easier to titrate off the medication.

Dr Sanjeev Sharma: [00:38:41] That’s correct. That’s correct. So what happens is a desert becomes a rainforest. OK, do we have to worry about water in rainforest? No. A rule of basic definition of rainforest is that there should be water there because otherwise, it’s going to be of the rainforest because that is natural amount of good quality soil is there, good quality of diversity is there, and there’s plenty of water is there. So once we create a rainforest environment and the system, then yes, some subgroup of people will require medications. No doubt about it. 

But the dose of medications will be less, which means less side effects. Chances are better quality of life. And as we mentioned other day, a tax liability becomes a taxpayer because this is very important. And that indexed percent patient whom I treated first time, I still remember him and I told him that like he was a teacher, he was almost at the end of his career and was on the verge of suicide because he could not cope with this recurrent depression. 

And what we did was I was using a combination of certain strategies, which he was having. So like, for example, in his case, he had challenges with full cycle metabolism. So and we provided certain nutrients, which was enhancing availability of methylated folate. 

OK, and this is a is suggested in Dr Stahl’s work, like those who have been in the field of medicine, knows that country knows that Dr Stahlhas recommended using some of these high dose nutraceuticals in that and elements of the mental health side.

Dr Ron Ehrlich: [00:40:34] High dose nutraceuticals referred to high dose vitamins or minerals.

Dr Sanjeev Sharma: [00:40:38] Yes, yes, yes. And it has been used. And when we use that, and I could see that within a span of weeks, this person starts to feel better. So when we are using some of these advanced panels of testings, yes, there’s a cost attached to them. And I don’t do that all the time. 

My role is always to start with the basic panels explaining them and tell them that, OK, in next few months, we will use some amount of dollars towards your testing. And then whatever the outcome of reports, the results are, we will use that towards interventions, but primary focus has to be on the diet because nobody likes to popping pills. 

And it’s not what’s the life going to be if you are given shakes and just pills and injections? No, that’s not about…

How big a problem is a mental health for health practitioners 

Dr Ron Ehrlich: [00:41:37] Sanjeev, it sounds to me like perhaps the term rather than smart pharmacology is a smart user of pharmacology, interposing that word, their practitioners, smart practitioners use of pharmacology. How big a problem do you think mental health is for health practitioners?

Dr Sanjeev Sharma: [00:41:56] Well, it is well known that […] of the majority of the major crises now. I clearly remember speaking with a few of my friends in India because when the COVID hit earlier this year and even last year when there was lockdowns, that we always have a tendency of getting the people to the hospital one day, somebody it’s not robots who are going to take over their care with it, that are human beings.

Now, if somebody has to wear a double or triple mask and appear to be into that like a jacket for hours and hours on their duties, how their morale is going to be. And there have been a lot of reports that, first of all, doctors do not. It’s well known they don’t take care of themselves, are sometimes they are ignorant of their health. 

And it is amongst several professions like doctors do have a high rate of suicide as well, so it is very important that if we have some colleagues or other parts of the world or wherever, a simple message, OK, how are you. It can make a big difference. It can make a big difference. And if I go back, there were studies done and people some who are presenting in the 80s. And they send a postcard note stating that you came on this and this date, you are in crisis. 

How are you? I hope you are doing well, OK? That itself prevented presentation. So sometimes these simple things are important, and usually, I would suggest that talk to your peers if you are under distress. Don’t, don’t suffocate yourself because often when people are getting suffocated, they can deviate towards addictions.

Dr Sanjeev Sharma: [00:44:12] And I’ve seen it many, many times that it can start with alcoholism or a, I guess are prescription medications, then it can lead to hard drugs. And also, if and do not shy away of saying that I’m not coping well and possibly speaking with your primary health worker and then start the journey because we are all at the first end of the day. First, we are all also human beings. 

We have emotions and we should not be taking it lightly. But the most important part do not take your health for guarantee because it’s well known that doctors do not sometimes take it up to help and get yourselves checked regularly. And it is very important that once your health is better, then chances are you will be able to serve what is going on others in the best possible way.

Dr Ron Ehrlich: [00:45:10] Hmm. Well, I think the symposium is going to offer an opportunity for us to collectively share that experience and make people appreciate that they are not on their own and that there are so many strategies that are available to them as practitioners as well as their patients.

Sanjeev, thank you so much today for joining us. There’s so much that you’ve said that has been so thought-provoking, and to hear it coming from a psychiatrist, a specialist, psychiatrist, consultant, psychiatrist like yourself is truly inspiring. Thank you so much for your time.

Dr Sanjeev Sharma: [00:45:47] Thank you. Thank you, Ron.


Dr Ron Ehrlich: [00:45:51 Well, I think it’s so inspiring to introduce you to integrative medical practitioners. Perhaps many of the people listening to this are already engaging with practitioners, or perhaps for some people, it’s a whole new concept because your doctor or your specialist really just orders tests or schedules medication, or a procedure or something like that. 

But I think the idea that there is an integrated approach that patients are such an important part of the healing journey, you know, I mean, if you’re outsourcing your health, if that’s how you approach, if your health, if the only thing you know about your doctor, about your health is your doctor’s phone number, well, you wouldn’t be listening to this podcast, let’s face it, but a lot of people do. 

A lot of people, the only thing they know about health is their doctor’s phone number, and they go and see their doctor for five, 10 or 15-minute consultations. And if they don’t walk out with a prescription, they don’t feel their doctor has done the job well. Well, there is so much more to health care, there is so much more to medicine.

Dr Ron Ehrlich: [00:46:57] Having said that, if you if that is the sort of patient that there is, well, there is a whole industry and there are literally thousands, if not tens of thousands of medical practitioners waiting to embrace you with open arms. It’s interesting because we did a podcast with Dr Martin Whitely recently who wrote this wonderful book Overprescribing Madness, and we explored the whole prescription of psychotropic drugs that Sanjeev was just was alluding to. 

But also, it’s worth mentioning that we, every health practitioner, studied biochemistry, and I wish biochemistry had been taught. I don’t know whether it has changed now. I don’t think it has. But if biochemistry was taught with nutrition, it would be just amazing. The fascinating subject similarly, histology, the study of cells and physiology, the study of how the body works, if that was all taught along with nutrition and disease, it would be a wonderful thing. But it’s not. 

It’s taught as a subject that you have to pass, and once you pass, you can then get on with the real work of learning about pharmacology and doing all sorts of interventionalists techniques.

So I thought it was terrific that Sanjeev shared those insights with us, and I loved his metaphors. And yes, he’s smart pharmacology well it turns out that’s actually the smart use of pharmacology, but that’s a whole other story. Look, I hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well. 


This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.