Are Thyroid Issues, Hidden Infections, Or Poor Sleep At The Root Of Your Mystery Symptoms?

Coming up on this episode of the Doctor's Pharmacy.

It affects one in five women, one in 10 men, and 50% of the time it's not diagnosed. Hey everyone, it's Dr. Mark.

Now, I know a lot of you out there are healthcare practitioners like me, helping patients heal using real food and.

Functional medicine as the framework for getting.

To the root cause of the issues. Now, in my practice, this often means looking at lots of internal variables to find the most effective path to optimize health. and reverse disease. But up until now, that meant we were usually ordering tests for one patient from multiple labs. Now, I'm sure many of you can relate to how time consuming and complicated lab ordering can be for functional medicine practitioners like me and our patients. That's why I love using Rupa Health.

With just a few clicks, I can.

Order from 30 plus lab companies. That's over 3000 tests for free in one single portal. That means one invoice for all labs paid online upfront. Plus, patients get practitioner pricing and receive full patient support through easier personalized collection instructions, automated follow up, super bills, and answers to testing questions and so much more. Just go to rupahealth.com, that's R-U-P-A-Health.com, to sign up for your free account today. No two people achieve optimal health in the same way. Age, genes, nutrition and lifestyle all play a part. That means in order to truly understand what's going on with your body, you have to start on the inside. And that's why InsideTracker takes a data-driven approach to health optimization based on your body's own signals. And now you can gain an even deeper understanding of your health with InsideTracker courses. InsideTracker courses explore the science of your health span, giving you the knowledge you need to live a longer, healthier life. And best of all, the first three chapters are available for free. Plus, you'll get access to an exclusive interview with Dr. David Sinclair that takes a deep dive into the science of healthy aging. To unlock the full 10 chapter series and bonus videos, simply purchase any InsideTracker plan. And for a limited time, you can get 20% off the entire InsideTracker store when you sign up at insideTracker.com/DrHyman. So head over to insideTracker.com/DrHyman to save today. And now let's get back to this week's episode of the Doctor's Pharmacy.

Hi, this is Lauren Fein, one of the producers of the Doctor's Pharmacy podcast. So many people are suffering from chronic mystery illnesses. They've tried doctor after doctor in search of a diagnosis that can provide them with answers. And yet for many, good health remains out of reach. In today's episode, we feature three conversations from the Doctor's Pharmacy. on places that doctors often fail to look at closely when treating patients with stubborn chronic symptoms. Dr. Hyman speaks with Dr. Elizabeth Boehm on the effects of thyroid imbalance and how to properly assess it, with Dr. Steven Phillips and Dana Parish on hidden infections that may be lurking in the body and causing harm, and with Drew Prott on why sleep deprivation is a.

Precursor to chronic illness. Let's dive in. How prevalent is this problem of low thyroid function?

You know, it's so prevalent. We see it all the time with our patients. You know, we see people who are really obviously low thyroid, and then we see people who are kind of that their thyroid numbers might be normal, but they have symptoms of low thyroid. So that would include things like hair loss. They feel cold all the time. They're constipated. They feel low energy. Maybe they've lost hair at the outer part of their their eyebrow.

Yeah.

And they've dry skin and they just feel crummy. Depression. Depressed, yes.

Concentrating, focusing, muscle aches, fatigue, getting tired in the morning.

Yeah.

All these weird things that people suffer from they think are quite normal, but they're not. And they're clues, you know? Right, they're clues to say, okay, we've.

Got to look deeper. We've got to figure out why are they not feeling well? And then we've got to figure out Is it their thyroid?

Yeah, and you know, it affects one in five women. It's so common. One in 10 men, and 50% of the time, it's not diagnosed. And I would say probably 80 to 90% of the time, it's not treated properly. That's true.

That's true.

So like, you might be one of the 10% that's got it nailed, but most of you, even if you have thyroid issues, you still may have symptoms. And the doctor's like, well, you're fine. You're on thyroid, don't worry about it.

Right, your TSH looks normal. I think we're doing everything we need to do.

Yeah, so what are the problems with the traditional way we treat thyroid in.

America around the world?

Well, I think the first thing that as functional medicine docs we recognize is that we're not asking that question why, right? So we're not looking for that underlying root cause, which so often helps us when we're treating our patient because it helps us figure out for them, for that individual person, what do we need to do to help their thyroid work better. So is it because of a nutritional deficiency? We know that we need iodine and selenium and iron and all sorts of good amino acids. Vitamin D. Just to get the thyroid.

To work on your cell, you need vitamin D to help it actually send the message to your DNA to do what it's supposed to do. Right, so- and 80% of us are deficient in vitamin D. Yes, yes.

And so if people aren't eating enough of certain foods, we might see nutritional deficiencies or maybe if their digestive system is a mess, they're not absorbing their nutrients well. So we have to ask that question why, 'cause sometimes that will just help the thyroid work better when we help support it nutritionally. Or maybe it's an autoimmune condition, like you mentioned, Hashimoto's. And then it gets us thinking of a lot of different things, right? It gets us thinking about, well, why.

Does this person have autoimmunity?

Isn't it the most common autoimmune disease? Yeah, it really is. What causes it? Well, you know, the body, in an autoimmune condition, the body starts to fight itself off, right? So it starts to, it looks at the thyroid gland and says, okay, I'm gonna fight you off, I'm gonna attack you. And when it attacks the thyroid gland, the thyroid gland doesn't work as well. And so then you get low, well in many cases you get a low thyroid. So what causes the autoimmune disease is the big question we always ask in functional medicine. That's it, why? Right, and everybody's different, right? For one person it may be gluten. We know gluten is associated with a lot of Hashimoto's thyroiditis, not all, but some.

My experience, like you look at thyroid antibodies and you compare it, with the gluten antibodies in that patient and it's about 30% of the time it could be related to gluten. What do you think?

Yeah, I think it could be. It could be. It might even be a little higher. It depends because of the patients we're seeing. So we might be seeing more patients who have a lot of different digestive issues going on and so I might see it even a little more frequently.

We call that selection bias. People who are sick select to come see us so they have more stuff for sure.

But we always think about the digestive system, right? You've got autoimmunity, you've got to think about what's going on in the digestive system. But then you think about could there be an overgrowth of bacteria? Certain bacteria in either the digestive system or other parts of the body have been shown to trigger autoimmunity in some people. We know that. We're gonna talk about that in another.

Podcast, so stay tuned. We're gonna talk about the gut and leaky gut.

Okay, we'll do that. We know that imbalances in iodine, actually excessive amounts of iodine. Can shut down the thyroid.

Yeah.

Hashimoto's, 'cause it was found first in Japan, where they have lots of iodine. So we know iodine's important for the thyroid, but too little's not good, but too much is also not good. So we pay attention to that. And toxins, of course, right? Toxins can be triggers for autoimmune disease in some people.

Yeah, some people say that the thyroid is a yellow canary of our body. That the yellow canary was the coal miner who used to bring the yellow canary into the mine, and if it dropped dead, they knew the air was bad, they had to get out.

Yes.

Right, so it was an early warning sign. And the thyroid is like that, and it seems to be extremely sensitive to disruption from heavy metals, from pesticides, the plastics and everything. Yeah, fluoride. Fluoride, yeah. So, yeah, fluoride in the water, all these things can disrupt our thyroid function.

And often your doctor never even looks for them. Absolutely, right? They say, okay, you know, we're just gonna look at the TSH, and if it's in the normal range, you're fine, or we're gonna give you medication to get it in the normal range, but not really look a lot deeper.

Yeah, so what is the difference in the testing that, oh, there's one other thing I wanted to bring up, which I remember reading about the New England Journal of Medicine, was a lady who thought that bok choy was healthy, and she ate like two pounds of raw bok choy a day, and she went into a hypothyroid coma. And people are having kale juice.

Talking about goitrogens.

Yeah, there's a whole kale craze. It's a great point. And people are juicing it and it's raw and raw cruciferous vegetables can be a problem.

Right.

If you're eating a lot of raw broccoli and cabbage and if you're having raw Brussels sprouts or raw bok choy.

Eating it in a level that's beyond just like a normal food portion.

Yeah.

Right, but as you mentioned, if you cook it, if you cook it, you get rid of a lot of that goitrogenic potential, that the part that's gonna dam or interfere with thyroid function. So you don't have to be concerned when you have cooked cruciferous vegetables, but.

It'S that, like you said, Should I.

Worry about having a kale juice every day? It's a good question.

Depends how much kale you put in it, right?

Well, I like to drink green juices.

And most of them have kale in them.

I mean, a little bit of kale is fine.

I'm careful about it, so.

And it depends on the person, of course, right? Right, you're an entomologist.

What about soy?

So, you know, that's a good question too. You know, I think that if, 'Cause.

A lot of people are like, soy is really bad, it interrupts your thyroid, it's dangerous, you shouldn't eat it.

I think if we're going with, you know, non-GMO organic soy as a whole food, like edamame and tofu, then I'm not concerned. Tempeh, I'm not concerned.

Traditional, soy foods that have been used for centuries, right?

Yes.

Miso, tempeh, tofu, the fermented soy too, right?

Yep.

Soy sauce. I mean, those are fine. It's when we're drinking a quart of soy milk a day, that's a problem. Or when you're having all these fake soy foods that are processed or soy burgers and you're eating stuff that's sort of weird Frankenfoods.

Or like the texturized soy protein that they put in cereals and bars just to get that protein content up. We don't, Yeah, that's stuff I tell people to stay away from. Okay, so you're someone who comes in.

You feel tired, you're constipated, depressed, your skin's dry, your hair's falling out, you don't have a sex drive anymore, you can't concentrate, and you go to a traditional doctor, they'll just test one thing.

What do they test? Right, so they typically test your TSH. Okay, so what is that? Your TSH is your thyroid stimulating hormone, and there's a feedback loop in the body. So if your thyroid level is low, then the body will get triggered to make more TSH.

And that comes from your brain, from your pituitary gland.

Yes, and then that TSH will say, okay, make more thyroid. So if the TSH is high, then the doctor says, okay, your thyroid is underactive and we need to treat it.

That's the only thing they test.

Often, often.

And I think you have your functional medicine doctor, a very different approach.

So what kind of things are you looking at? Well, we always, we always start with a full thyroid panel where you look at TSH, but you look at free T3 and free T4. So free T4 is one thyroid hormone that's floating around in your body, but then the T3 is the active form that your body needs for all the thyroid functions to occur. So we look at both, we look at all three of those at least. And we often look at thyroid antibodies. And sometimes we'll even do things like reverse T3 and the reverse T3 to total T3 ratio.

So there's- what is reverse T3?

So the reverse T3 is a thyroid hormone that the body, when the body is, I always think of it almost as the brake that the body puts on itself. So when the body is saying, okay, I've got to slow myself down, it takes some of its T3, which is your active thyroid hormone, and it converts it to reverse T3, almost in a way to slow down our metabolism. It's a protective mechanism, I think of, right? And it makes sense that we have that in times of stress.

A lot of people actually trigger that.

That are not actually that's actually good, right?

That's very true. So, like, if there's a, you know, if there was a major stress going on, you'd wanna have that mechanism in place so you didn't starve to death. But with a lot of chronic stress, which we see a lot these days, we can sometimes see high reverse T3. And the other thing we see a lot that causes that high reverse T3 is sometimes toxins. So it can be a sign that we've gotta look deeper and say, okay, is this person under a lot of chronic stress? how is their adrenal gland functioning? How are they working to activate that parasympathetic nervous system, that calming nervous system, which helps the body heal? And then we look for toxins. Yeah.

In the gluten issues, we look for everything that is imbalancing the thyroid. So we look for nutritional deficiency, selenium deficiency, iodine deficiency, are you low in zinc, do you have low omega-3 fats, do you have yeast in your gut, do you have heavy metals, do you pesticide exposure, toxin exposures. So we take a very detailed history that your traditional doctor would not do. Right. To really look at the broad spectrum of what's causing it, because we could just treat the symptoms of the thyroid, but maybe we may not need to do that. And I've seen many patients where you fix these other things and their thyroid gets better. Absolutely.

And it's so powerful when you see.

That, it's like, oh, I don't need to do thyroid. I can actually fix the upstream cause. Yeah. It's pretty impressive when you see that.

It is.

And the last thing you were talking about was antibodies.

So, Tell us about what antibodies are and why we should look at them and why traditional doctors don't look at them?

I'm not sure why they don't look at them enough, but the antibodies are giving us a signal that the body is attacking its own thyroid and it's a sign that there's autoimmune disease going on in the body. And we've gotta figure out that question, you know, why is that? Why is that going on?

Yeah.

And, you know, so I had a woman who came in to see me and she was 40 and she had been struggling All those symptoms we talked about with low thyroid, you know, she was cold all the time, you know, her hands were cold, she was gaining weight, she was tired, she was constipated, she was losing hair, her eyebrows were thinning.

Sound familiar to anybody?

I know, right? So I'm like, okay, but then her primary doctor did her TSH and it was normal. So we then went deeper.

Can I stop you for a second? So what I was trained, and I'm sure you were trained the same way, was you only check TSH. If that's normal, then you don't do anything else. And what's normal is a range of like 0.5 to 5.

Often, yeah.

Which is a massive range that actually doesn't reflect even our current understanding on most reference ranges on the lab tests that even the American College of Endocrinologists says if it's over three and a half, we should be worried.

Right, and many, many studies are saying people between one and two feel the best.

Right? Right.

And I remember, you know, because I always do all the tests. I don't do reverse T3, but I do TSH, T3, T4, and the thyroid antibodies. Because what I've learned is that even if all those are normal, TSH, T3, T4, you can have elevated antibodies.

Yes.

And people who have those feel better when they get on thyroid.

Very true.

And I went to a conference years ago at Harvard, and I, you know, it was a traditional medicine conference, and the endocrinologist was talking about thyroid. And he said, look, if your antibodies are elevated, they should be treated because they're probably symptomatic and you treat the patient, not the lab test. But in traditional medicine now we're more.

Treating the lab test, not the patient. And I think that's really important. And the physician sometimes thinks, well, I'll just wait until these antibodies damage the thyroid enough and then I'll treat.

Right.

That's the way they, you know. It's like once the TSH starts to go up. I'm gonna wait until, but we say.

Okay, no, there's so much we can do. 100%. There's so much we can do right away. Yeah, I remember this patient came in once with, blood sugar like 115 and 126 is diabetes, 100 is pre-diabetes. And I'm like, God, did your doctor say anything about your high blood sugar? Oh yeah, he checked it out. Well, what did he say? He said, well, when it gets to.

Like 126, we'll treat it with medication.

Yeah.

I'm like, no, this is the perfect.

Time to treat you. So tell us about this case. So right, so she came in and she wasn't feeling good at all, but her TSH was normal. So we did the full panel and we saw that her thyroid antibodies were elevated. And so then we had-: what was.

Her TSH and the rest abnormal or not really?

No, her TSH was pretty normal. I can't remember exactly, might have been a little on the high side, but I don't even know if it was. I think everything looked really normal, right? yeah, looked good, right? But she had those thyroid antibodies. And so I had to ask that question, why, right? Why do you have these thyroid antibodies? And then it brought us down this whole pathway of what's going on with her digestive system, what's going on with food sensitivities? Was there any signs of increased intestinal permeability? And so we pulled her off of gluten and we measured things like her iodine level and her selenium level just to get the right balance. And we actually, we gave her some thyroid hormone. We gave her some glandular thyroid hormone. I used Armour thyroid on her, which is a combination of T4 and T3. And she started, she really responded well. She felt better. She noticed her hair starting to come back in, her skin starting to be less dry, her bowel movement's improving. And so, you know, I think it's important that we take that step and go a little deeper.

And people don't often realize how bad they're feeling until they start feeling better.

On this stuff, right?

And I think just to back up a little bit, you know, you did something which was kind of unusual, controversial, and most traditional endocrinologists would scoff at, which is you used a combination of T3 and T4 in a hormone that comes from pig, that is the entire thyroid combination of hormones, including T2, which we don't even talk about, that is actually really important to replace your own because you make a complex array of hormones and often the T4 can't get converted to the T3 in your body, which is the active hormone. So even if you're taking T4, which is what most doctors recommend like Synthroid or Levoxyl or any of these, and they're not terrible, but they're just challenging because you actually may not be giving the person the T3 that they really need because their body's not able to make it as well.

Right.

So then we ask that. So some people, as you mentioned earlier, feel fine on T4 thyroid hormone. That's like Synthroid or, you know, so they do okay with it. But a large percentage of people don't, and that might be because they have deficiencies in nutrients that help the body go from T4 to T3, right? So they might be deficient in in iodine or selenium, as we mentioned, in vitamin A or iron and zinc. We talked about that earlier that they can't make that conversion as easily and so the medicine doesn't work as well for them. Or it may be because they have a variation in a gene. We know there's this gene. It's kind of a really, I mean, really interesting low impact type of gene. So what that means is that it, It's not going to kill you. Right, thank you. It's not going to kill you, but it can make you not feel so good. And it helps us know how to treat people. So the gene, this DIO2 gene that encodes for this enzyme, the DIO2 enzyme, which helps the body convert T4 to T3, especially in the brain, but also all throughout the body, and make that active T3 thyroid hormone. And what we're learning is that some people have this gene variation, and so when you give them just T4, thyroid hormone, they don't get the benefit. And studies have shown even when lab work looks normal, so even if their T3 looks normal, even if their TSH looks normal, that they do better when you give them some T3, which could be like a glandular thyroid hormone, like Armour, which is a combination of T4 and T3, or it could be a synthetic T3. We sometimes use like cytomel and we'll add that to Synthroid, for example, or a T4. And so sometimes we see those people who just start to feel better in terms of, especially mentally. Energy-wise, mood-wise, they really start to feel better finally.

They don't realize that depression is really linked to thyroid and that often psychiatrists In treatment resistant depression, when drugs don't work, they'll give them T3 as a treatment for depression.

They've been doing that for a long time. It's not anything new.

Right, right, right.

It's weird for the rest. And also, the T4 thyroid replacements, there are challenges with that because there's often fillers, things like lactose and gluten even.

Could be other reasons why people don't feel well on those.

So those are important to recognize. And a lot of the traditional doctors really scoff at the use of glandulars like Westhroid, Nature-Throid, Armour Thyroid.

Why is that?

And should we be worried?

You know, I don't think so. I think maybe during their training or many years ago, there was a question of regulation of those or the dosage, but I don't find that to be a problem at all. We can definitely regulate dose with our patients. It's very reproducible. in terms of the medication. And I mean, a good portion of our patients, I think we've talked about this before, right? We'll say, maybe it was 80% of our patients or a good portion of our patients do really well when we use a glandular. I mean, there are some that don't. There are some where that might actually cause more autoimmunity, maybe, for some, or they just don't feel good on them. And we use synthetic. but for a good portion, it works really well.

Hey, everyone, it's Dr. Mark here. If you've been following me for a while, you know that I often talk about how eating organ meats is so good for your health. Now, I know it can be hard to work them into your diet, but when we don't eat things like liver, kidney and heart regularly, we're missing out on wonderful sources of essential nutrients. Organ meats are nature's multivitamins and the richest sources of natural vitamin A, B vitamins and minerals that we have. But liver isn't everyone's first choice for a delicious meal, which is why my friends at Paleo Valley created their grass-fed organ complex supplement.

Supplement.

Paleo Valley Grass Fed Organ Complex contains three different organs from healthy grass-fed pasture raised cows. So you're getting a wide array of nutrients and each ingredient is sourced from a family run farm in the US. It's then gently freeze dried in order to preserve as many of the nutrients as possible. The end result is an odorless, tasteless, burpless supplement that offers all the benefits of organ meats in an easy to swallow capsule form. If you're struggling with brain fog, low energy levels, or if you just want to optimize your health and vitality, try Paleo Valley Grass Fed Organ Complex. and right now, Paleo Valley is offering my listeners 15% off their entire first order. Just go to paleovalley.com/hymen to check out all their clean Paleo products and take.

Advantage of this deal. And now, let's get back to this.

Week'S episode of the Doctor's Pharmacy.

Tell us how you kind of figured this out. How did you come up with this hypothesis and what made you interested in this idea of chronic infections and autoimmune disease? Because even though we know in medical school we learned a few immune disease may be related to infections.

It wasn't really a predominant theme.

Right.

So thank you. So I've been in practice since '96 and I started treating lots of Lyme patients. And at that point, Lyme was the infection that got all the intention. And for a lot of us, it's the one that any of us has heard about. We haven't heard about these many other chronic infections. But people come in with diagnoses of, is it Lyme? Is it MS? Is it Lyme? Is it fibromyalgia? Is it Lyme? Is it inflammatory arthritis? and I would treat them for the underlying infections that I found and what was diagnosed as a possible autoimmune illness just kind of evaporated. And I would see it time and time again and it wasn't all Lyme. I was looking for other chronic infections and finding them. And then I came upon the realization about the fact that there's this precipitous rise in chronic and autoimmune illness around the world has been like this slowly exploding, exploding pandemic rather than as opposed to COVID, which has just taken the world by storm. this has kind of just crept up on us over the last 30 years. And, it's shockingly common and because it is siloed, because it's between different medical specialties, no one's really putting the pieces together about why is this happening? Because the infections have been here forever and like you mentioned, we're living in an increasingly toxic environment. I think that a lot of us are less able to deal with infections that are common in the population.

So, what what happened to you? I mean, tell us about your journey with chronic infection.

What didn't happen? What happened?

So.

A lot. Yeah, I went through the mill. So I first got lime, just regular garden variety lime, like so many people do that live in Connecticut. And it was a moderate case. It wasn't dramatic. It didn't disable me. But I realized by going to many infectious diseases doctors and ultimately ending up in the office of doctors like myself, Lyme doctors, that there's real discordance among the medical community and how they approach chronic illness. And they didn't. No one seemed to know what was going on. I gradually got better, and I had many relapses, and it. It wasn't a three course of doxycycline that got me better. And. And then I was really fine. I still had occasional relapses, but I was a healthy guy. I could run, like, five miles. I could play tennis all day and work six days a week, which I did for many, many years. Then in 2010, while I was sleeping, I got spider bites, and I didn't think anything of it. And with those spider bites, a couple months later, my body exploded with arthritis all over, rapidly Progressive to literally every joint in my body, especially my spine. And I went to 25 doctors that couldn't help me. I went to other doctors like myself who thought it was maybe prior Lyme, but I was the only one that's saying it wasn't and. none of the antibiotics that helped me previously helped me for this case. And I went to rheumatologists who diagnosed me with rheumatoid arthritis and spondylitis, which is arthritis in the spine. And it progressed very rapidly within six months, despite treatment with different medications, including many antibiotics. I couldn't walk and ended up not walking for almost two years. I had to give up my practice for two and a half years. I was completely bed bound for about a year and a half. And I almost died on many occasions. I lost 50 pounds. I couldn't turn over in bed. I couldn't sit up on my own. I needed 24-hour home care. I got severely anemic and I had fevers 102 every night. It just. It was a dire situation. And I figured out in the last minute and put it all together and I saved my own life. And I'm. It's not just, like, save my life. I'm back to a full life and. I, back in practice since 2013, you know, I lecture all over the place before COVID traveling around the world and, you know, not limited in any way. And when I went back to my three top rheumatologists when I recovered and I told them, you know, this is how I got better. Will it change how you practice? Like, no, I'm glad you got better, but we're not gonna, we're not gonna change.

Tell us more.

What, what actually got you better? What you did to recover and what was the root of cause? Because functional medicine is really about looking at the root causes of disease, and this is really what you're doing, you're looking at not just a label that people get like rheumatoid arthritis, but what's.

Underneath it and how do we fix it? I went to regular doctors and I went to functional medicine doctors as well. Like I said, I went to every specialist I can find and I did the elimination diets. I didn't find any heavy metals or anything like this. She wasn't able to help me to be perfectly honest. And I took lots of antibiotics that flared me up but didn't get me better. And really it came down to that my infection was Bartonella, which is antibiotic refractory infection, and it needed really just specific antibiotics. And that's what got me better. I took lots and lots of herbs that didn't help. And at first, I wasn't a believer that herbals were helpful. And then I took my first herb to rock my world, and it caused this huge Herxheimer and massive Improvement. And that was liposomal Artemisinin. And I was like, oh, so that's how an herb's supposed to work. And. And then I ended up getting tremendous benefit from liposomal oil of oregano and. my second herbal and then monolaurin. So there were a few supplements and herbals that were found really, really beneficial, but primarily for me, it was antibiotics. It was things like doxycycline and rifampin and Bactrim.

And, yeah. So those antibiotics, you know, are strong antibiotics, but, but Bartonella is really one of those tough infections. It's one of those tough infections.

It's often hard to find and hard to treat.

And so, you know, people suffer for years from leading things like this. And I've seen people literally for decades have problems, and then you treat them.

And they get better. It's pretty miraculous. No. I went back to a hematologist and they looked like I was a Martian. I mean, one was delighted that I got better. One treated me like it can't be like in disbelief. And I did a little dance in front of him to try and convince him. I mean, because he saw me not walking and I was like, look, I'm dancing. I'm not a good dancer, but, and then one was just looking like I was a one off, like I'm a one in a million case. And she's like, look, one in a million things happen. I'm like, I'm not one in a million. I mean, I always, my mommy told me I'm special when I'm a kid.

But I don't think I'm one in a million. And I think there are other people that have very similar things. yeah, yeah. That's funny. I remember giving a talk at Harvard, and I was presenting about a case of autism that had dramatically turned around. And one of the pediatricians there was like, well, you know, this might just be a case of spontaneous remission. And then one of the other doctors, well, Dr. Hyman's had, like, five cases of spontaneous remission. His practice is here so far.

Yeah.

If you, if you understand what, what the roots are. And you also talk about in the book, your dad, who had pretty bad heart failure and needed a heart transplant.

No, he did not need a heart transplant.

He was going to need one. So, what was the discovery there? Tell us about your experience.

That's what galvanized my interest in doing what I do. It wasn't my own case. Like I said, my case of Lyme was pretty moderate and I wasn't planning on doing this as a career. But when I started learning about this, my heart, my father had had a case of what they thought was a viral meningitis in 1975. And then shortly after that became a non-specific heart palpitations and it got just worse and worse. Then he turned to atrial fibrillation, a specific type arrhythmia. And then he went into heart failure. And we took him to all the best doctors in New York City, all the top teaching hospitals. And we don't skimp. We went to the best and they all couldn't save him. And he got worse and worse, an ejection fraction. between 10 and 20. They said that his lifespan would be measured in months without a heart transplant. And I was just finishing up my residency at Yale. I was doing Lyme research. I'd already had some experience with Lyme personally. And I was like, looked it up, and I was like, holy crap, Lyme can do this. So I went to the cardiologist. I said, you know, Lyme can do this condition, dilated cardiomyopathy. Can we evaluate him? And he rolled his eyes and discounted the whole thing, and. you know, they published a study in 2015 where they looked at people with his type of condition, his type of heart fire, went in and did heart muscle biopsies on all of them and found that 20% had Lyme DNA. They made a point in the study to say that almost two-thirds of them had negative Lyme tests. So if you don't really have a big suspicion about what these infections can do, you're going to miss it. And I've treated about 50 cases.

See, what you just said was really important. I don't want to, I want to emphasize it. You say that 20% of the biopsies in the heart muscle were positive, but two-thirds of the people who had the positive test had a negative blood test. So, in other words, you can get a blood test, it can look fine. Your doctor says your labs are fine, you don't have Lyme, but actually if you look deeper, you can actually find it because it may not always show up in the regular lab test. It's an important point.

Yeah, you have to ask yourself who goes and gets a heart biopsy to diagnose Lyme? It's the silliest thing. The tests are antiquated, they're like 40 years old. I would say I won't get on a 40 year old airplane. I'm not going to trust my health to outdated technology with blood testing. But long story short, he wouldn't evaluate him because my dad never had arthritis and he didn't have a bell's palsy. He said, you,'re a doctor now, do it. I was just, you know, a fresh out of school basically. And, I basically treated him and his heart function completely normalized. He's 88 years old now. He never needed a heart transplant.

He's not in heart failure at all.

And that's the story.

That's incredible. So what you're saying is essentially you've cured an incurable condition according to traditional medicine with treatment of his Lyme disease, which was causing his heart failure. And I think, I think this is sort of under important to underscore because so much of what we see in, in, in my world, in your world, people who are suffering from chronic illnesses who just don't get better bounce from doctor to doctor and are often misdiagnosed because doctors often don't have a framework for looking at root causes. And, you know, functional medicine is this framework for looking, whether it's heavy metals, which I've had, or Lyme disease, which I've had, or Babesia, which I've had, or Mercury, which I've had, or mold, which I've had. You know, these are things which are typically ignored by traditional doctors. Even diet, for God's sake, which is more obvious, is often also ignored as a root cause of so many chronic illnesses. And I think what you're talking about is that there is hope for people. who suffer and who struggled if, if they can figure out how to get to the right person, which is not always easy, but to even advocate for yourself and say, look, I've got this problem, but I'm not giving up, and I'm going to go kind of dig until I find what's going on. And, yeah, it could be a number of different things from, from a perspective of causes that can cause the same syndrome. So you can have rheumatoid arthritis, but it could be heavy metals, it could be gluten, it could be lime, it could be Bartonella, it could be all kinds of things. But we, we basically just lump everybody into the same category. Oh, you've got rheumatoid arthritis, or you've got this or that disease. and we go, we know what to do. We give you the drug for that disease, but it doesn't really speak to the cause. And that's really what you guys have been talking about. It's so, it's so refreshing to hear you talking about that. So, Dana, I want to sort of jump to you for a minute. You got sick, and you also developed a Lyme-induced heart failure, and you're a pretty young woman. And you sort of talk about how you got a tick bite and a rash, and, and everything kind of went downhill from there, and you went to doctor after doctor until you kind of found Dr. Phillips and got treated. So tell us about your story and how you ended up being treated by Dr. Phillips and what happened to you and how you got better.

Sure.

So it was the summer of 2014. I was truly at the prime of my life. You know, I just signed a brand new deal with Sony and just wrote their songs for Celine and I was supposed to be traveling all over the place and I was incredibly happy. So I say that because when doctors start saying like it's in your head or you're making it up, or you just want attention. Those kinds of things are absolutely insane to me because so many people are like me where they get really derailed at the prime of their lives and nobody would make this stuff up. It's absolutely devastating. So, I got a tick bite. I saw the rash. I got it within five days. I caught it because I knew when I got back from New Jersey and got back to Manhattan where I lived and I saw it. I was lucky that I was in the minority that saw the bite and the rash on my shoulder. Most people never see it and many strains of Lyme do not produce a rash and many other tick-borne infections produce no rash. So that's an important thing for people to know. So I went right over to urgent care. I knew it was Lyme. They knew it was Lyme. They gave me three weeks of doxy-cycling, an antibiotic, and said, you,'ll be fine. Go on with your life. They also told me not to Google Lyme and that I would get scared and that I don't want to be a crazy Lyme person. That was a clue that something really weird was going on. I had no idea that this very common, ubiquitous infectious disease that drives a pandemic of illness was a political hotbed. I had no clue. So I do take the doxy cycling. I try to move on. with my life. And three months later, I wake up, all hell broke loose. The first symptom was that my breast was swollen overnight. I had all these fibrocystic changes and extreme pain. Went to the internist. She sent me, she panicked. She sent me to an oncologist that day at Mount Sinai. He ruled out cancer. He agreed my breast was swollen. He agreed this was weird, didn't know why, just knew it wasn't cancer. sent me on. I went to go on to have fibromyalgia, exercise-induced incredible weakness. There was a little gym in my building. I did my same lame workout that I do all the time. And just one day my arm stopped twerking in the midst of all this. Literally couldn't lift a fork, couldn't feed myself, couldn't walk my 29-pound dog. And I went on to have incredible body pain, brain fog, visual disturbances, anxiety, depression, intrusive suicidal ideation where I literally couldn't stop thinking about jumping out my window, but I didn't want to, but I couldn't stop. It was something, it was like a monster took over my brain and my body. I went on to see three infectious disease doctors, tons of internal medicine and the oncologist and sports medicine and nobody had any answers and what the, you know, I would ask them, especially the ID guys, Could this be related to the tick bite? No. Why not? Because you took the three weeks of doxy and it's cured 100% of the time in the test tube with doxy. Okay, that's actually totally not true. The other reason that one of them gave me, this is my favorite, this well-known doctor at NYU said to me, because I went to medical school. So I'm like, well, ticks carry other infections too. Is there anything else? I was pushing them at some point. I said, Do you want to test me for inflammatory markers? Like anything? He goes, oh, that's a pretty good idea. Okay, well, this is my third visit with you. Are you kidding me? So I went on to have this horrible experience until December when I went into heart failure. And then everybody really got serious, really believed me. I mean, I do think some of them thought it was in my head because I had so many weird, disparate migrating symptoms. that doctors are complete, when they don't understand something, they put you in the psychiatric bucket. You know, that's, that's a theme. I think, of course, you, you know that very well.

So.

And when you, when you have these things, you do feel crazy because nobody can give you any help. And also the fact that it's changing all the time and every day, it really feels crazy. So then in December, I went into heart failure. My ejection fraction was 40%. under 50 is considered heart failure for people who don't know. And yeah, yeah. And it was, I mean, I was so healthy before all of this. So then, thank God, I had a friend who knew about Dr. Phillips and seen him testify at some hearing and, like, knocked it out of the park and said, you know, you got to go see him. He's brilliant. And he's the only person I would see if I was in your position. So I went to him and he saved my life. And Within like two months of seeing him, my heart failure totally resolved. And he did talk to the Mount Sinai cardiologist who had been very concerned about it, did take my heart failure seriously, just didn't know the cause. And Steve really educated him about Lyme carditis. He didn't really even know very deeply about it. He was interested and he was educable. He was the only one, but he was, and I really appreciate that. but I was treated with a rotating course of antibiotics, antimicrobials, Chinese, I did a Chinese herbal protocol as well called the Zhang Protocol. There are plenty of them of different Chinese medicines you can take. That was the choice I made because I lived in Manhattan and it was in the city and I could see them. And anyway, Dr. Phillips really came in and got me better. It was a miracle.

Yeah.

Well, I hear this story so much that people often suffer and they really struggle with trying to figure out how to get the right treatment. But, you know, I think what you're speaking to is, is they need to think deeply about rethinking medicine and rethinking how we approach disease.

What are the consequences of chronically not getting enough sleep? Is it just that you're tired or are there deeper issues that can have almost like permanent damage on the body? Absolutely. I mean, I think we were just.

Recognizing the dangers of sleep deprivation in terms of its risk for chronic illness, heart disease, cancer, diabetes, Alzheimer's. depression, anxiety, mood disorders of all sorts. So it's a real thing. And I think if we don't take it seriously, we're going to be missing the boat on a very important intervention and helping to address some of these chronic diseases that goes far beyond diet or exercise. The other thing that happens is your brain at night has a system of cleaning, cleaning and repair. So you need to have the, what we call the lymphatic system working. The lymphatic system is like the lymph system of the brain. that's recently been discovered and it's so important. It really is activated at night. So, if you're not sleeping at night, you're not clearing out the brain waste and you're gonna have a brain full of sludge and waste products that are metabolic waste and toxins. So, it's so important for that particular.

Reason too to make sure you have adequate good sleep. I know there's a little bit of controversy around this and a lot of different opinions, but from your perspective, how many hours of sleep should we be shooting for in the evening. I mean, it's very individual.

Some people do fine on six hours, some people need nine hours, and you need to find out what your number is. Everybody's different. But the amount of sleep where you can feel good and energetic and your quality of sleep is deep. I mean, if you sleep six and a half hours and it's like, you know, a ton of deep sleep, a ton of REM and really reparative, and that might be enough for some people. Other people might need nine. I need about eight. My nine, I love if I can get it. But it really makes you feel much more vibrant and healthy and functional. So I think, you know, it's certainly more than than seven ideally, and probably between seven to nine hours is a good amount. And again, as I said before, you know, the last century, about half of us, I mean, sorry about the average age of the average number of hours of sleep a night was like nine hours. Now it's seven or less.

All right, next question. What are commonly overlooked issues that drive poor sleep? unexpected things, things that people may not know that expand on that first list that you gave us when we were opening the episode.

Yeah, I mean, I think people don't understand the role of their overall pattern of being and living. So first thing is when you wake up, you should get 20 minutes of sunlight without sunglasses on because it resets your pineal gland, which makes melatonin regulates your circadian rhythm. So we want to keep our circadian rhythms in balance. The second thing is, you know, our diet plays a huge role. And, and particularly, you know, if we're eating a diet that's, you know, high in starch and carbohydrate, we're having fluctuations in blood sugar. We may actually even at night get hypoglycemia, and that can really disturb our sleep. We can get night sweats. You know, men often get night sweats, too, but that's often usually low sugar. And then the cortisol spikes, and you get a spike in sugar in the morning. So that's a real problem. so I think the other thing is, you know, people are probably consuming a lot of alcohol, caffeine, sugar, all these Disturbed sleep, chronic stress. You know, if you're not actually discharging stress, a lot of people go to bed tired and wired, and a lot of people have adrenal issues, so they're pushing so hard in their life that they actually don't have a chance to reset and relax their nervous system. And that leads to incredible amounts of cortisol production, cortisol Disturbed sleep. I mean, if you take prednisone for whatever reason, it's going to mess up your sleep. So stress plays a huge role. Exercise, I mean, you don't want to exercise too late in the day that can often activate you. So there are, you know, a lot of things that can drive poor sleep, lack of magnesium, which is common in the country if we don't eat magnesium in the forms of greens and beans, greens, sorry, greens and beans, nuts and seeds that we end up with magnesium deficiency, which affects about 45% of the population. people don't sleep well when they have low magnesium. It can be irrita, cause irritability and tension and stress and then plus caffeine and chronic stress and smoking, a lot.

Of other things will cause magnesium depletion. So you wanna make sure you're getting plenty of magnesium. Talk about sleep in your life. What are the things that, now at the age that you're at and your schedule, what are the things that throw your sleep off? And, what are the effects that you notice in your performance the next day when your sleep is thrown off?

No, yeah, I mean, it's huge. I mean, if I'm traveling, you know, I'm trying to stay in one place longer, but it depends on the bed and the pillows, the sound, the noise, the temperature. I mean, I can get messed up and given all the years of screwing with my schedule and sort of staying up all night, I definitely have sleep issues, but I've learned how to actually mitigate them by, you know, making sure I do a bedtime wind down ritual, by making sure I take my bedtime supplements like magnesium, a little melatonin. And, and, and if I don't get quality sleep, I notice in the next day I can't focus, I can't think, my brain is like distracted. It's hard for me to be present with other people. It's hard for me to feel motivated to do anything. I know as I get a little depressed, but it's not, I know I'm not depressed. I just know it's a sleep like a sleep. So I, I think, you know, very attentive to sleep, but I you know, sometimes it's hard, you know, when you're out with friends and you're traveling, you're on vacation, it's a little tricky, but mostly I'm pretty good about getting to bed by 10:00, 9:30, 10:00, sometimes a little bit later and try to sleep, you know, read a little bit. I have a light, which is a reading light that's a kind of an amber light that has no blue light in it. So I don't have to leave the light bulb on on the bed. So I try to come down from the light. I have blue blocker glasses at night I use. that really helps. And so that all benefits me.

Talk to us about how conventional medicine typically treats poor sleep when a patient is going through it and contrast that with functional medicine and how a functional medicine doctor would look at addressing poor sleep quality with a patient.

So from a traditional medical point of view, I mean, there are reasons for people's lack of sleep that a conventional doctor will look at, whether it's sleep apnea, restless leg syndrome. There's sleep studies that doctors do that can be very revealing. A lot of people have undiagnosed sleep apnea. The ultra Wellness Center. We now have a home sleep study kit, which allows people to kind of get tested and do it at home, which is great. However, you know, often there's really very little to do from a conventional perspective other than, you know, direct recognized basic sleep hygiene. And then there's a CBT sort of approach cognitive behavioral therapy, which helps people deal with sort of the mental aspects of insomnia. And that can be very effective. Cleveland Clinic has an online program called SomRest, which is available. So there's a lot of really useful conventional approaches to help people reset their sleep. However, there may be a lot of other causes from a functional medicine perspective for sleep disruption. The traditional medicine just says, oh, do therapy or take these sleep pills or practice better sleep hygiene, but they don't really say, well, why is your sleep disturbed in the first place? This is why why we're so effective in functional medicine. Because we don't want to know just what you have.

Insomnia.

We don't know why. Why are you're not sleeping? Is it because your thyroid's not working? Is it because you have chronic stress and adrenal burnout? Is it because you have low magnesium? Is it because your microbiome is inflamed and causing inflammation in your brain? Is it because you might be hypothyroid, which can cause a little bit of sleep disruption? Or is it because, you know, you have a bad sleep environment or because your. Your sleep habits are terrible or because, you know, we go through all the underlying causes. and then, and then we, and then we dress those, whatever they might be. You know, it's amazing to me, Drew, I, I, I never would have thought this was the thing, but when we put people on the 10-day detox diet, when we put people on elimination diet and get rid of, you know, processed food, sugar, dairy, gluten, grains, Etc. It's amazing how many people report, oh, my sleep got so much better. I'm sleeping so much deeply. I feel so much better. I'm like, well, wow, I don't know about that, but I think what happens is there's inflammation in the brain, and inflammation will interrupt sleep. And when you start to live an anti-inflammatory life, you actually will end up with, with a much better sleep quality.

Little anecdote is that my dad many years ago, when we put him on a version of the 10-day detox and he had been eating bread his whole life because he grew up vegetarian and still was vegetarian when he was doing the program. One interesting thing that he noticed is that when he had cut bread out of his diet, he noticed this chronic back pain that he had at night that would make it harder for him to fall asleep went away because the inflammation went away. And that then made it easier for him to fall asleep. And so, he got a better night's rest.

There you go. Yeah.

Talk to us about another patient and a case study that you can think of. where sleep was the missing link that allowed them to get into a better state of health. Anything that comes to mind?

Well, I have two. One was this guy who was very smart editor of a major, major sort of Sunday kind of magazine newspaper. I mean, you would all know what it was. and, you know, his team was like, he's just falling asleep all day in the office. I'm like, it's terrible. He's not. He's not able to function. Well, it's annoying. I'll fall asleep with meetings. I'm like, well, tell me about your life. He says, well, I drink, you know, 12 Cokes a day and have 12 cups of coffee a day. I'm like, oh, okay, well, maybe caffeine is a problem. So we got him off the caffeine, and we put him on an anti-inflammatory diet, and it was amazing. He just completely turned around and was able to, you know, be able to function again. There's another case I remember, a young, we're not young, he was about a 50 year old. He's young to me now, but 50 seems very young to me. And he was a lawyer. And I'm like, well, tell me how you're doing. He's like, well, I want to lose weight. I'm kind of overweight. And he had the big belly and pre-diabetes. And I'm like, well, tell me about your life. And well, you know, I said, you sleep okay? Oh, yeah. But, you know, during the day, I, I use a stand-up desk. This would be before stand-up desk where even a thing. And because if I sit down, I'll fall asleep while I'm working. And I'm like, wow, okay, you probably have sleep apnea. So I said, let's test you for sleep apnea. And he sure enough had sleep apnea. We put him on a CPAP machine, which is breathing machine to sort of stop CPAP, he literally lost 50 pounds just like that and felt so much better. And, you know, we corrected these underlying issues around sleep and metabolic health. The thing is, if you don't sleep, you also crave carbohydrates, you crave sugar, you crave, you know, all the, the junk that's going to make you gain weight. And we know this even from studies on young, healthy adult college males who are not overweight when they deprive them of two hours sleep a night. compared to the control group, the ones that had the two-hour sleep deprivation ended up having higher levels of ghrelin, which makes you hungry, and PYY was lower, which is the appetite suppressing hormone. And so they had hormonal changes that made them crave more carbohydrates, eat more food, be hungrier, gain more weight. And so really the key to often healthy metabolism and weight is actually sleeping.

A lot of people at night notice that their mind is running and it just won't get quiet and that impacts their sleep. I know you have a lot of experience with meditation and different protocols that you've used either personally or recommended to people in the past, but is there something that you could suggest that those individuals could try when it comes to winding down at night and getting ready for bed?

Absolutely. I mean, I think, you know, when you think about it, it's kind of silly. We like, go, go, go. We're answering emails at 11 o'clock at night. We're looking at our screens. We're engaged in all kinds of stressful, emotional, psychological things with your work or whatever. And then we're like, okay, lights out, boom, go to sleep. And people are exhausted, but they'll often fall asleep and then often wake up frequently because they got the stress hormones going in their body. So, I think really having a sleep ritual at night is so important for me. It's very important to get off screens at least a couple hours before bed. I often will take a hot bath with Epsom salt and lavender which calms my nervous system down. I'll put the little kind of amber light that has no, it's like a reading light that has no blue light. Turn all the other lights off. I'll read a little bit in bed and the reading and the calming down just calms it down. The other thing I can do often is I'll write a little before bed. So, I'll literally dump out whatever in my head. I'll just write it all out and I'll just just completely purge anything that is a negative thought pattern in my head. Am I worries for tomorrow? What happened that day? Whatever, whatever. And I just try to let go. And the other thing you can do is a little yoga stretching before bed, a little deep breathing exercises before bed, get a little massage before bed. You know, all those things can help. You know, if you're a partner, you can rub each other's feet. That's a very relaxing thing to do. I have a Theragun, I'll often use that to kind of relax my muscles and nervous system. You have to find out what's right for you, but it really requires some level of decompressing and unwinding before you get into bed because if you just plop into bed after running 100 miles an hour, it's like you're not gonna fall asleep.

I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in.

Hey everybody, it's Dr. Hyman.

Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health. and get healthier and better and live younger longer. Just a reminder that this podcast is.

For educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make.

Changes, especially when it comes to your health. Don't forget, there's a way to listen completely ad free with Hyman plus on Apple podcasts. You can enjoy every episode without any breaks.

Just open Apple podcasts and tap try free to start your seven day free trial.