Psychiatrists and Psychologists

Despite a great financial health care system, suicidality rate of South Korea has been the most frequent than any other countries for the past decades. Meanwhile, emerging evidence shows that human endocrine system is closely related with severe psychiatric conditions recent study shows that alteration of thyroid function is one of a major cause so as to alleviate or aggravate psychiatric condition. But the reality is shameful: Even reference values of TSH and free T4 are still under debate; consequently treatment protocol for thyroid dysfunction has also been chaotic. Otherwise, there seems no doubt that vitamin D has a pivotal role from synthesis of thyroid hormone and progesterone to gene expression of non-humane symbiotic existences. Our study showed that in the general population of South Korea, sunlight alone could not synthesize vitamin D enough to maintain clinically relevant blood level. More than taking 4000 IU every day is required for the clinical healthy state of human body but also to the symbiotic existences in the body, most prominently mitochondria and gut microbiome. Only a few months ago, we overvalued probiotics function which include Bifidobacterium or Lactobacillus species and stigmatized Fermicutes such as Coprococcus and Dialister. But the latter groups are now revealed as “real allies” to human by the courtesy of Belgium study, which was published in Feb 2019. We also studied which kind of prebiotics is more beneficial between XOS and GOS and concluded that XOS is safer than GOS in the aspect of comfort and safety. Since lots of psychiatric patients are under hyper-sensitive state of immune system, prebiotics which mainly consists of GOS might result in unexpected disruption of endocrine-immune interaction, which aggravate symptoms. Considering gut microbiome-microglia interaction, our study concluded that gut microbiomes themselves are a kind of variable, huge, flexible endocrine organs, which produce neuro-transmitters, endocrine hormones to immune modulators directly and indirectly. The products which they make interact with central nervous system via lymphatic vessel in the brain, which found only four years ago. Needless to say, if this interaction is disturbed by some reasons, local inflammation occurs in the specific brain region, like basal ganglia, which is related to OCD. For mitochondrion in the microglia cells not to be dysfunctional; like the case of gut microbiome, we ask help again to vitamin D. which encounters Vitamin D Receptor (VDR) of mitochondria, rather than nucleus of our somatic neuron, to express mt DNA and surprisingly they make essential proteins for human to live. We suggest all knowledge above should be considered when practicing regardless of physician's specialty.