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A Functional Medicine Approach to Psychosis, Schizophrenia, and Bipolar Disorder

Psychotic disorders, including schizophrenia and bipolar disorder, have increasingly been linked to inflammation and immune system dysfunction. 

What we know:

  • Autoantibodies (e.g., anti-NMDA receptor antibodies) have been identified in some patients, suggesting an immune response against the brain.

  • The gut microbiome plays a significant role in mental health. Dysbiosis, or imbalance in gut bacteria, is common in patients with psychotic disorders.

  • Gastrointestinal inflammation and conditions like IBD, IBS, and celiac disease are prevalent in these patients and may contribute to psychiatric symptoms through mechanisms such as increased intestinal permeability (leaky gut) and systemic inflammation.

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What we address through a functional medicine approach:

  • Assess for causes of inflammation: Infection, toxins, gut dysbiosis, immune markers

  • Improve vagal nerve function

  • Reduce gut inflammation: Studies show that gut inflammation can lead to the production of brain-reactive antibodies and activation of the brain’s immune system (microglia and astrocytes).

  • Improve the integrity of the Blood-Brain Barrier: Inflammation can compromise the blood-brain barrier, allowing immune cells and inflammatory molecules to enter the brain and potentially trigger or exacerbate psychotic symptoms.

  • Evidence based dietary changes to repair the gut and decrease immune system activation and inflammation. Dietary antigens (e.g., gluten, casein) can trigger immune responses in sensitive individuals, leading to increased inflammation and psychiatric symptoms. Dietary interventions, including anti-inflammatory or ketogenic diets, probiotics, and prebiotics, show promise in managing these conditions.

  • Reduce metabolic side effects of psychiatric medications including weight gain and mitochondrial dysfunction.


Careful clinical history and symptoms as well as functional lab testing including inflammatory markers, stool testing, and organic acid testing.  Individualized treatment plan includes addressing relevant contributors for the individual.  

Follow ups:

Dietary change counseling, targeted supplementation, and treatment of underlying causes of inflammation as well as adjustment of medication as needed.

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