The Walsh Protocol and Biochemical Imbalances

I attended my first Walsh Research Institute Physician Training Program in October and am very excited to have learned about several frequently occurring biochemical imbalances that are present in many people who experience many different types of mental health conditions.  This information was brand new to me, and was never taught in either medical school or in my residencies.  Dr. Walsh has had decades of experience and has been involved in the assessment and  treatment of tens of thousands of people with one or more of these imbalances.  Often his treatments result in a significant reduction or even elimination of the need for prescription psychiatric medications and a great deal of improvement in the mood, behavior and functioning  of people who previously had very serious mental health problems.  Examples of the conditions the Walsh Protocol has addressed include Autism, Attention Deficit Hyperactivity Disorder, Depression, Anxiety, Obsessive Compulsive Disorder, Bipolar Disorder, Schizophrenia;  it has also been helpful for people developing Alzheimer’s and other neurological conditions.

There are several common biochemical imbalances that appear to be an underlying cause of many mental health conditions.  The determination of which imbalance(s) are present in any person is a multiple step process.  The first phase is generally done through an interview.  The person is asked about a series of traits, both related directly to mental health but also to physical traits or symptoms or even personality characteristics.  Each imbalance has a large number of traits that are often present in people who have that imbalance. Although few people have all of the common traits, it is considered significant if a person has 40% of the traits for that imbalance.  A Walsh practitioner, Dr. Heermann,  has developed a computerized screening questionnaire that I have purchased and use to gain the information that the interview provides.  The benefit of this Screening Test is that it can be completed outside of the limited time during a session, scores the answers based on an algorithm that ranks the importance of each trait, and provides a physical report that can be charted and referred to in the future to compare how someone is progressing with their treatment.

The second phase in the diagnostic process is obtaining specialized laboratory testing.  This includes some of the commonly gotten tests such as a Metabolic Panel, TSH, Vitamin D, CBC, Homocysteine, Hemoglobin A1c, and C-Reactive Protein.  In addition, some unusual test are also obtained – a serum copper, plasma zinc, ceruloplasmin and whole blood histamine.  A test for Urinary Pyrroles is sent to a Specialty Lab.

The Common Biochemical Imbalances are as follows:

  1. Methylation Problems – This biochemical process, which occurs constantly in all of the cells in our bodies,  is the result of a combination of our genetic makeup interacting with our environment.  Thus stressors as well as positive situations can turn genes on or off, and thus help or hinder the body’s natural ability to repair.  Methylation is involved in many of our most vital bodily functions, by offering support and/or managing, such processes as: 1) Detoxification; 2) Controlling inflammation; 3) Maintaining DNA; 4) Immune function; 5) Energy production; 6) Mood balancing.
    • Undermethylation – (i.e. not enough methylation occurring in the cells); clinical features include depression, obsessive-compulsive (OCD), perfectionism, seasonal allergies, competitiveness, and internal anxiety.
    • Overmethylation – (i.e. excessive methylation occurring in the cells); there is a tendency for high anxiety, panic disorder, depression, chemical and food sensitivities, music/artistic ability, and empathy for others.
  2. Copper Excess – Copper is an essential trace element but excessive levels are toxic to the body.  Copper overloads tend to lower dopamine levels and increase norepinephrine in the brain.  Imbalances in these important neurotransmitters have been associated with anxiety, postpartum depression, ADHD, autism, violent behavior, paranoid schizophrenia and bipolar disorder.
  3. Copper/Zinc Imbalance – both copper and zinc are important minerals for proper functioning of biochemical processes; however, they must be in proper amounts relative to one another. Copper and zinc levels are regulated by metallothionein, a short linear protein composed of 61 amino acid units. When this protein fails to perform its necessary functions, abnormal levels of nutrient metals (such as copper, zinc, and manganese) and toxic metals (such as cadmium, mercury, and lead) can result. Nutrient treatment to eliminate these overloads must be cautious and gradual to avoid worsening of symptoms and kidney damage. Zinc enhances resistance to stress and help maintain intellectual function, memory and mood levels.  More than 90% of persons diagnosed with depression, behavior disorder, ADHD, autism and schizophrenia exhibit depleted zinc levels.   Zinc deficiency has been associated with delayed growth, temper control problems, poor immune function, depression, poor wound healing, epilepsy, anxiety, neurodegenerative disorders, hormone imbalances and learning problems.
  4. Pyrrole Disorder – Pyrrole disorder (or pyroluria) is detected by the presence of elevated kryptopyrroles in the urine. During the synthesis of hemoglobin, particularly in the bone marrow and spleen,  there are waste products generated called kryptopyrroles.  Kryptopyrroles don’t really serve any useful biological purpose and are normally excreted by most of us uneventfully.  In someone with pyroluria, however, these kryptopyrroles don’t get excreted and will tend to build up–even more so under stress of any kind.  Kryptopyrroles have a tendency to bind very strongly with nutrients such as zinc and vitamin B6, making them largely unavailable to the body…which is a very big problem.  Zinc and B6 are nutrients critical for the functioning of your entire body and mind–including your digestion, immune system, cognitive functioning and emotions. Over time deficiencies can majorly affect way you feel and function and have serious consequences.  Often people will go for years suffering the effects of pyroluria regardless of what therapies they try or how well they eat.  Pyrolurics also have a greater than normal need for omega-6 fatty acids, particularly dietary arachidonic acid (AA–found readily in eggs, butter, red meat and liver) and the essential fatty acid GLA (gamma linolenic acid– found in supplements like black currant seed oil and evening primrose oil).  This test represents a marker for functional deficiencies of Vitamin B-6 and zinc, and elevated oxidative stress. Symptoms include:  poor tolerance of physical and emotional stress, poor anger control, frequent mood swings, poor short term memory, reading disorder, morning nausea, absence of dream recall, frequent anger and rages, depression and high anxiety.
  5. Heavy Metals and other toxins – proper brain function requires the complex interaction of chemicals; it is well established that certain toxic substances have the potential to disrupt normal brain physiology and to impair neurological function. As well as headache, cognitive dysfunction, memory disturbance, and other neurological signs and symptoms, disruption of brain function may also manifest as subtle or overt alteration in thoughts, moods, or behaviors. Over the last four decades, there has been the unprecedented development and release of a swelling repertoire of potentially toxic chemicals,such as heavy metals, pesticides, plasticizers and other endocrine disrupting or neurotoxic compounds, which have the capability to inflict brain compromise.

There are other causes as well for Mental Health symptoms and conditions, so if a person does not have any of these imbalances, there are still helpful treatments available.  It is just  wonderful to have another way to both understand and treat some of the issues that previously either did not or only partially responded to conventional treatments.  Treatments for the imbalances vary depending on the person’s situation, and responses vary form within a few weeks to taking many months.  As these imbalances are generally a combination between an inborn, genetic issue interacting with the person’s environment, the need is often for the person to remain on the nutrient therapy indefinitely.  The treatment is not a “cure” but instead a treatment for a problem with handling metals, vitamins, detoxificant, etc.  The risk of stopping the therapy because of feeling well is relapse.

Attention Deficit Hyperactivity Disorder

A public presentation on ADHD and Autism will be held on Sunday, August 7 at 7:30 pm at Simple Gifts Massage, Ellicott City, MD by Phyllis Heffner, MD of Holistic Child Psychiatry, LLC of Columbia, MD. RSVP at or The first 10 people to attend will receive a free Metabolic Health Analysis and book on Lifestyle Medicine.

Attention Deficit Hyperactivity Disorder (ADHD) and Autism are 2 conditions that occur in both children and adults. They are generally considered to be brain based and not due to psychological causes. Conventional medicine, including Psychiatry, Pediatrics and Neurology, looks at the symptoms of these challenges, makes the diagnosis and generally recommends treatment with medication for ADHD and either medication if the person with autism is aggressive, depressed or anxious or will state that there is no medical treatment available.

Holistic and Integrative Psychiatry looks at these conditions quite differently. Rather than just assuming the symptoms are due to neurological condition, the possibility that the symptoms are secondary to other challenges are also explored. Treatment then is determined based on the underlying cause of the symptoms- this could be nutritional and diet related, exercise, sleep, nutritional supplements, herbs, stress reduction techniques, treatment of infections or removal of toxins. Medications are also sometimes indicated, depending on the situation. There is not a typical treatment protocol but must be individualized depending on each person’s situation.

Some options available to diagnose ADHD include the traditional Psychiatric Evaluation and behavioral checklists completed by parents and teachers, neuropsychological testing, and brainwave assessments. Holistic Child Psychiatry offers the CNS-Vital Signs, a computerized neuropsychological testing platform that measures attention, memory, cognitive flexibility and other factors.  I also offer the NEBA, a FDA approved brainwave test to help clarify the clinical diagnosis of ADHD.    Another form of treatment offered is brain mapping and LORETA Neurofeedback, in which the brain learns how to change its current brainwave pattern to one that is more functional and may prevent the need for medication.images

Thyroid Dysfunction and Mental Health

Manyimages-4 people have symptoms of thyroid disease. Hypothyroidism often results in symptoms of extreme fatigue and sleep difficulty, hair thinning or loss (especially at the eyebrows), weight gain, cold intolerance, depression, dry skin, high cholesterol, menstrual and fertility problems, and muscle soreness. Many of these symptoms are similar to depression. Hyperthyroidism can look like mania or even psychosis, with increased energy, lack of sleep, agitation, anxiety, restlessness, weight loss, rapid heart rate, sweating.

Because of the typical way most doctors test thyroid function, they are told their thyroid is “fine” and that they are either depressed or stressed. The test that is most often obtained is called the TSH, which measures the hormone from the pituitary gland in the brain that tells the thyroid to make thyroid hormone (hypothyroidism). Too much TSH means the thyroid is not making enough hormone while too little means too much hormone is being released (hyperthyroidism).There are several reasons for these problems, including the thyroid gland itself not working correctly, the pituitary not secreting TSH correctly, conversion from the inactive hormone T4 (which is made by the thyroid gland) to the active hormone T3 in the cells, to an autoimmune attack on the thyroid gland.

In order to adequately evaluate how well the thyroid is working, 8 different tests are necessary, not just the TSH. These tests will help determine if thyroid problems are involved in the depressive, anxiety , mania or other symptoms you are having, and will help determine the appropriate treatment. Everyone with symptoms of depression and anxiety deserves to have their thyroid tested, because if it is the underlying cause of their problems, treating depression or anxiety with psychiatric medication is likely not going to be helpful!

For more information about thyroid dysfunction, digestive system problems, adrenal fatigue and other medical conditions that can look like mental health problems unless they are suspected and tested , I encourage you to attend the Public Presentation on the Relationship between Physical and Mental Health being held on Sunday, AUgust 21, 2016 at 7:30 PM at Simple Gifts Massage Co, 3567 St. John’s Lane (entrance on Frederick Road), Ellicott City, MD. Email to or call 410-260-0344 to RSVP. the first 10 attendees will receive a free Metabolic Health Screening.

Anxiety and Depression Presentation









You are invited to attend a free public presentation on Sunday, August 28, 2016 on Depression and Anxiety, to be held at Simple Gifts Massage Co. On Frederick Road in Ellicott City, MD. Please RSVP to the Facebook event on this page or so that we know how many chairs and the amount of healthy refreshments are needed.

Both anxiety and depression are among the most frequently experienced mental illnesses among all age groups. Infants and toddlers frequently experience separation anxiety; although this is a normal part of development for some children it becomes extreme and they become terrified if their “safe” person is not visible at all times. Losses and trauma, including abuse, also can result in anxiety as well as depression in everyone, no matter their age. Older children and teens have a much higher rate of depression and anxiety. These conditions can lead to school refusal, physical complaints such as headaches and stomachaches ,social withdrawal, and even self-harm and suicidal behaviors. In adults, depression is the second most common cause of disability, and is closing in on #1. These conditions can be due to physical health problems, such as hyper- or hypo- thyroidism, food allergies, traumatic experiences, genetic tendencies, negative thoughts, and many other issues.

Mild cases of anxiety and depression can often be temporary, not significantly affect the rest of a person’s life or functioning, and may not require any specific treatment. More serious episodes, those that are longstanding, prevent functioning in school or work, make someone feel miserable and result in social withdrawal, sleep or appetite changes, panic attacks, fatigue and lethargy, suicidal or self harm thoughts or behaviors require additional evaluation and treatment, both to determine safety and to improve the situation.

There are many forms that treatment for anxiety and depression can take. Conventional treatments include individual and group therapies, often focusing on cognitive-behavioral or other forms of talk therapy. Medications can also be prescribed – these work for some people, don’t for others and have the risk of interactions and side effects. For the most serious forms of depression, ECT or Transcranial Magnetic Stimulation are sometimes used.

Integrative and more natural/holistic treatments often start with diet and lifestyle modifications – focusing the diet on real, whole foods and eliminating processed foods as well as gluten, dairy and sugar and any food sensitivities an individual may have, exercise and sleep are also critical components. Nutritional deficiencies are corrected, sometimes amino acids are added to give the body building blocks to make neurotransmitters, herbs and essential oils can be used as well. As some people’s depressions are very sensitive to light, a light box can be helpful. Other treatments can include Emotional Freedom Technique (“Tapping”), EEG Neurofeedback, Heart Rate Variability Training, BodyWork, meditation, yoga, Qi Gong and Tai Chi among others.

Conferences I have Recently Attended

It is the start of conference season! I have attended 3 really interesting and useful conferences since the end of January, and have both learned as well as had reinforced information that is relevant and critical for the assessment and treatment of patients in an integrative, holistic Psychiatric practice. It is important to know about many different issues in order to determine both the underlying cause of mental health problems, as well as treat each person’s needs individually and effectively. Brain, Body and Behavior (and Moods) are all closely interconnected and influence each other in many and complex ways. Read more

The Gut Microbiome and Mental Health

What does the 3-4 pounds of microbes (which includes bacteria, viruses, yeasts and molds, parasites and other microscopic critters) that live in your gut have to do with your mental and physical health? There are many more of these microbes than all of the cells of your human body, and they contain many times more genes than our approximately 22,000 human genes. The types of microbes vary depending on the environment that they are exposed to in your gut. If you eat processed food, they are different than if you eat whole organic food. If you exercise the types and amounts change. Read more

Announcing the Opening of Holistic Child Psychiatry, LLC

Holistic Child Psychiatry, LLC

Phyllis J. Heffner, M.D.

is pleased to announce the opening of her private practice of Holistic and Integrative Psychiatry

Thursdays  and Fridays from 8 AM to 6 PM

and Saturday mornings from 8 AM to noon

at: 104401 Shaker Drive, Suite 103;   Columbia, MD  21046

Accepting patients of all ages who have either emotional or behavioral challenges, gastrointestinal distress, or hormonal imbalances such as thyroid, adrenal or insulin resistance who are interested in exploring medical treatments that include much more than just medication. Contact Dr. Heffner for a free 10 minute educational consultation, and to schedule an initial evaluation.

Telephone and fax: (410) 260-0344

Due to the nature of the practice, I do not participate with any insurance plans. I can provide a detailed receipt you can submit if you have out of network benefits.

Anxiety treatment for better tomorrow

Anxiety is something that exists in everyone’s life to a certain extent, and in a way it is medically known to be helpful as well. Because, anxiety helps us stay alert and be reactive to our circumstances, whether joyful or painful. However, when the anxiety reaches the stage where it overwhelms you mentally and physically, and affects your normal routine of life, you need the help of an experienced clinician.

Read more

How to improve your memory?

It has been believed for centuries that as we grow older, our brain functions continue to deteriorate, which also impacts and weakens our memory. However, recent medical researches and experiments have proved that our brain has the ability to grow new neurons, even as we age, a process known scientifically as neuroplasticity. The mental health of a person depends vastly on how active the person is – physically and mentally. If you keep forgetting things too quickly, or have noticed a sharp decline in your mental health in terms of memory recently, it is time to make some really important changes in your lifestyle to help sharpen and improve your memory.

Read more