Ask Mark Q&A #7: Grains, Sleep Hacks, Fatty Liver, And More

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

Most people don't realize it's not fat that makes you have a fatty liver, it's starch and sugar. Hey podcast community, it's Dr. Mark Hyman. And right now, more than ever, we need a strong immune system. And that is why I'm offering my eight-part Sleep Masterclass free to my entire community. If you want to get access to my free course, and reclaim your sleep, go to DrHyman.com/sleep and sign up today free. That's DrHyman.com/sleep. I want to take a moment to tell you about something really exciting, my first ever shake called the Pegan Shake. After years of trying to discover the best breakfast meal protein powder or shake recipe and coming up short, I decided to create My own. The Pegan Shake is 100% clean and combines healthy fats from MCT oil and avocado oil with organic and grass-fed protein from collagen, pumpkin seeds and pea protein and extra fiber to create the perfect way to start your morning, balance your blood sugar and energize your day. These ingredients are also great for fueling your mitochondria and for fat burning. So far, hundreds of people have been trying the Pegan Shake and here's what some of them have had to say. Suzanne M says, Highly recommend the Pegan Shake. Great flavor, curbs cravings, and love the fact that it has healthy fats. And it's great for digestion. I love it and I'm going to order it again. Laura B says, I love starting my day with a quick filling smoothie, but I was never full until lunch. My attempts to supplement my own fell short. The Pegan Shake includes the protein, fiber, and fat that provide the nutrition and energy I need. I'm so grateful. for the Pegan Shake. This shake is designed to support your blood sugar and keep you feeling full and satisfied while giving your body the best information and nutrients to thrive. I know you're going to love it as much as I do. Check out the Pegan Shake at getpharmacy.com/pegan-shake. That's getpharmacy with an F, F-A-R-M-A-C-Y, forward slash Pegan Shake. Now let's get back to this week's episode of the Doctor's Pharmacy. Hey, everybody, it's Dr. Mark. How you doing? I'm so excited to be here again with this new format of a live Q&A show that I'm doing for my whole community. So welcome. We're calling it Ask Mark, and it's where I take questions from my text community and invite those people to come on live and ask me their question. Now, we have about 10 to 12 people that are going to join us today to ask their question. If you want to ask a question in the future, all you have to do is text me 413-555-5555. 225-8995. That's 413-225-8995. With the hashtag AskMark. And my team might pick your question in the future and you get to chat with me personally. Now, I can't give medical advice, so if I do, I'll go to jail. So I can't tell you how to fix your problem, but I can give you a big picture advice of how I would approach various challenges with people's health. So let's go right into our first guest. Do we have Zach? Welcome Zach. What's your question? Good, what's your question? So I have heard you mention that you consume black rice occasionally as one of the like grain sources I've heard in a couple of your podcasts. And I'm wondering today if you consume any other grain other than black rice. and then my follow-up to that is if we are buying organically, shopping local, and we've tested ourselves and we don't have too much of a problem with grains, what are your top ranked grains? Great. Okay, perfect question. So, you know, I've finished my new book called the Pegan Diet, which tries to be inclusive instead of reductionistic, which is what most diets are. And, and I talk about grains in the book. And if you don't have certain health issues, right, I'm just going to put a caveat on it. If you don't have severe digestive issues or diabetes or certain autoimmune diseases, grains can be a healthy part of your diet. If they, if you have any of those conditions, it may, it may be a problem. So I think it might be, it might be tricky if you have a lot of grains, if you have digestive issues, autoimmune disease or diabetes, or if you're overweight, which is about 75% of Americans, but you look pretty skinny and healthy. So that's okay. So I, I actually have some grains. If I don't, I, I actually I lose too much weight. I probably shouldn't say that in public, but I like sweet potatoes and little starchy stuff because it keeps me going because I'm very active and do a lot of exercise. So if I'm picking grains, I love black rice. It's the blueberries of grains. It's essentially full of proanthocyanidins, which are powerful antioxidants. It's much lower in glycemic index, so it doesn't raise blood sugar as much, and it tastes good. And it's called forbidden rice or the emperor's rice. 'cause it was a very rare form of rice that was used in China. So I love black rice and I would say I have a half a cup, but I don't have it every day. I have it on occasion. There are other grains that can be actually okay that are quote non-grain grains. So wild rice is actually not a grain, the seed, that's fine. Buckwheat is actually great and there's an incredible variety of different buckwheats. One of them is Himalayan Tartyary Buckwheat, which I write about in the book, the Pegan Diet, which is coming out in February. and that is a really unusual form of Himalayan buckwheat that is one of the most powerful superfoods on the planet, full of immune boosting properties and antioxidants. So that's a great food and there's ways to get it through different vendors, although it probably will be more in production over the next few years. Quinoa is great, although quinoa is higher in protein and also has a lot of antioxidants. The problem with quinoa is that we've we've made it such a sexy grain that the South Americans who were relying on it for their main source of carbohydrate and grain, which is very healthy, can't afford to buy it anymore because all the fancy Westerners are liking it. And they are actually having to eat rice and other grains that are super starchy and there's increasing rates of obesity and disease. So it's really a problem. Also, there's other grains that you can use that are weird grains, things like amaranth or teff. which are gluten-free grains. Those are things you can use. Other grains, like millet can be okay, although that can be a little starchy. And I think if you are non-gluten sensitive, not everybody is, I think I would stick with kind of weird forms of gluten-containing grains, whether it's spelt or rye or triticale or other forms of gluten-containing grains that might not be as bad as Western wheat. If you are going to eat wheat, I would definitely encourage you to get wheat that's not from America because of the way we breed it. It creates a lot of issues. It increases the starch content. It increases the gliadin proteins which cause celiac and gluten sensitivity. It increases the problems of glyphosate, which is often sprayed at the end of harvest to dry it out to make it easier to harvest. You're getting glyphosate right at the end of the season, which is a microbiome buster. And it's all preserved in this country with something called calcium propionate, which is a neurotoxin. So, and that's why kids get all wigged out often when they eat wheat. And plus it produces all these excitotoxins, glutamorphins, which can be very neuroactive and trouble for your brain and be very addictive. And that's why, you know, we eat about 133 pounds of flour per person in America every year, which is a lot. So I'm not a big fan of that. There are heirloom forms of wheat, there's Kernza wheat, which is grown by West Jackson out in Kansas. It's a very cool form of wheat. That's very deep roots. It builds soil. creates a sort of a regenerative agriculture cycle. It's a perennial wheat. There are also forms of wheat like Einkorn wheat, which is an heirloom grain wheat. And so there's heirloom grains that I think can be fine. But, you know, just pay attention to your body, how you feel, how's your digestion, what happens to your weight, metabolism, insulin levels. You know, eating it as part of a nutrient dense meal with good fats and protein can be fine. Awesome. Is oats listed all like steel? Oh, yeah. Oh, it's so. It's so. Someone's gonna ask about oh, it's okay. so, you know, often oats are gluten-free or gluten-free oats. Well, there was a review of, of very interesting review of oats. It said they were gluten free. And when they, they analyzed them in a lab, they really weren't. So, and I, I've seen this over in my practice. If someone's gluten sensitive, really gluten sensitive, unless they get off oats, they're not going to get fully better. So I think oats are in the same category. If you're going to have oats, you know, have the steel cut oats or, or whole oat groats, which you can make, not even steel cut, just whole oats. and that can be better. I think that's much better than refined oatmeal, which is very high glycemic and will put on weight. Okay, awesome. Thanks so much. Thanks, Jack. So, Anne, I think we'll have, I'll be our next guest. Hi, Anne, how are you?

Hi, Dr. Hyman, thanks for having me.

Of course, good to see you.

Thank you. My question is about sleep. I've had problems with waking up at night around three o'clock, the same time. And then once I wake up, I can't fall back asleep. And so my question is, could this be related possibly to adrenal dysfunction? I'm assuming I'm having cortisol at that time of night.

Yeah. So cortisol is something we all need. But when our circadian rhythms are out of balance, when we don't have the right regulatory pathways that are controlling our cortisol and melatonin, we tend to be dysregulated. And if you're under chronic stress, which we all are now, given COVID, given politics, given climate change, given the economy, you know, given the divisiveness in our society, I mean, I just feel really unsettled by what's happening in the world as most of us do. And I'm very fortunate I, you know, have a job still, but I just, I think it is a stressful time. And of course, you know, whether work is stressful, relationships are stressful, life is full of stresses. So the question is, you know, how do you tend to regulate your circadian rhythm and cortisol and melatonin in a more effective way? And I think there's a lot of good science about this. First of all, it's really important to get morning sunlight, you know, for 20 minutes or so without sunglasses first thing in the morning if you can get outside for a little walk. really great to affect your pineal gland, which resets your circadian rhythms in the morning. Really important at night to wind down and often we go, go, go, go, go and then drop into bed and like go to sleep. We're tired, we fall asleep, but then we wake up because we're still in an activated state. So, create a bedtime ritual, you know, maybe in a couple hours before bed start to wind down, read a book, stay away from screens, get off your email, get off your phone, use blue blocker glasses to deal with the light pollution that is really often a problem. Make sure that you engage in practices to reset your adrenal glands. And these are things that have been used throughout history, whether it's meditation or yoga or deep breathing or guided imagery or hypnosis, I mean, whatever you like. There's all kinds of apps and Insight Timer and a number of different really great great apps that you can use to sort of calm yourself down. I think those are really important. Taking a hot bath often will help. So with Epsom salt, Epsom salt is a very powerful muscle relaxant because the magnesium, glutathione, detoxifying, you add some lavender drops in there and that lavender, they make lavender baby bath because it actually calms the babies down. And, and a science knows this. Johnson and Johnson makes this and, and the lavender will will lower cortisol before you go to bed. Sometimes taking a little extra melatonin before you can bed can help, a little magnesium to calm your nervous system can help. And so you sort of stack all these things together can really be able to be effective. And then, you know, it's your mindset also, you know, what's your mindset like? How are you, are you, are you, are you, I mean, I, I, I'm a victim of this, too. I mean, like, I, you know, the news is very disturbing right now. And like today, I've been on a house cleaning project and I I didn't pay attention to the news and I feel so much happier. It's like, you know, there really is very little good news out there. It's unfortunate. There's a lot of good news happening. It's just not reported on. And so it's not, it's not something that we can actually control that much, but we can do a news fast. We can, you know, coffee is another thing. It tends to rev us up. Caffeine, if you're really struggling, can be a problem. Cutting out alcohol at night, it can be really helpful. And so stacking all these things together, you can start to re-chain your deep rhythm and really help a lot. No Ziva meditation is a great online course for meditation. It's 20 minutes twice a day. So powerful for me. It's. I couldn't live without it. I just. It helps me to sort of drop in, slow down, stop, get off the merry-go-round for a minute and be with myself. And it's. It's almost like three hours of sleep, you know, when you do a deep 20 minute meditation. So I encourage you to explore all that and. And. if you are struggling, there are adaptogens, mushrooms and various kinds of herbs that can be really helpful in your cortisol. We sell something on our online store, drhyman.com, called cortisol manager that can help at night. You can take a few of those in magnesium. So there's some supplements that can often be helpful too. So a lot of information. I've written a lot about this. You can Google Hyman sleep. In fact, we have a whole sleep master class. which you can go on our website and find out and learn. There's lots of experts and lots of guidance about how to do these things. It's like five hours of instruction. So that's available as well. So no lack of information. I hope this was helpful.

Okay, thank you. Appreciate it.

Sure. And our next guest is Christina. Welcome. Unmute yourself, my friend.

Oh, I knew it was going to do something. I was going to say, I'm so excited to finally meet you. I have like three of your books.

Oh, thank you.

And like, what the heck to eat to so many people. But I basically, I have true celiac. I'm having a baby in two weeks, so I will.

Congratulations.

Thank you. I already eat gluten free and I already eat grain free. But during this pregnancy, I've had to eat gluten free bread. toast for morning sickness and rice for morning sickness. So I haven't really been grain free this whole pregnancy. But I was thinking, my question really is, is I want to go back to the Pegan diet again once I have the baby. And I was wondering, is that something I can do during nursing or is it, should I continue to do that?

I love these questions. Can I eat healthy during pregnancy? Can I eat healthy during nursing? No, I think you should go to McDonald's.

Yes.

We should drink six Cokes a day and have 14 Oreo cookies because that's proven to be safe. But eating vegetables, having whole foods, not having chemicals, pesticides, I don't know, we don't know much about that. I'm forced to eat that kind of.

Diet because I have- I'm kidding, it's.

A funny question because nobody, is it okay for mothers to eat junk food? Is it okay for mothers to eat sugar? Is it okay for mothers to drink milk and have dairy when they're pregnant? Probably not, right? But people wonder, is it okay to eat a healthy Whole Foods diet? Yes, of course it is. In fact, not only is it okay, it's essential when you're pregnant and when you're nursing because you're literally programming your genes of your baby. There's a phenomena called epigenetics, which is a really fascinating discovery in the last few years that we can tag our genes. So think about your genes as fixed. You've got 20,000 genes. They're coding for their hard kind of, that's your hardware, right? But, or when it was, and then what happens is the software is what gets read off of those genes, right? So for example, let's say you have a Word program like Microsoft Word. You know, there's so many features you don't even use, right? Like it depends on which ones you activate. So when you are pregnant and nursing, you are literally tagging or activating different genes in your baby that will program its later health consequences. In other words, if you eat junk, you will be programmed the baby for diabetes, cancer, and heart disease. You know, if you eat whole foods, you'll be programming it for health. So it's really critical when you're pregnant and nursing to really double down on eating well. because if you don't, you're literally programming your baby for a later stage disease in their life.

Oh, okay. That's good to know.

Yeah. Well, thank you so much. That's a great question. Okay, Rezan is next. We've got one more question now from hi.

Hi, Dr. Hyman. So I drink the recommended amount of water every day, but my thirst is never quenched.

What can I do? Great question. Well, there's a couple of issues there. So just in general, you know, a lot of people don't realize that if you drink too much water, you will actually dilute your blood. So, you know, people say, oh, you know, you shouldn't do this or that, 'cause it's toxic, but, you know, water can kill people. In fact, it's not uncommon for, for example, marathon runners or athletes who drink enormous amounts of water when they're exercising to actually dilute their blood so much that they get hyponatremic, meaning their sodium levels drop. And, when that happens, you can get a seizure, you can get brain damage and literally die. And, it happens. So, the key to really staying hydrated, not just in your blood but in your cells, is electrolytes. Sodium, potassium, magnesium, and sometimes calcium. There's a lot of stuff out there you can buy that has electrolytes. Be careful, some of it has a lot of additives and chemicals and weird sugars and stevia and weird things. But, there's some really great brands out there. E-Lyte is a great one. It's just very, doesn't taste very good because it's just, there's no sugar in it. Light Show, L-Y-T-E show is quite good. Tom Brady's TB12 makes different flavors. Those are good. I carry them with me and I just put it in the water I drink. Tom Brady never drinks any water without electrolytes. So, it's going pretty strong at 43 and he keeps winning. So, it must be something to that. So, electrolytes are really, really important. Now, there is a condition that is called SIADH, which is a syndrome of inappropriate ADH secretion. I doubt you have that, but it can often be a condition where your normal hormone that regulates your urination, right? It doesn't work. So you're just peeing all the time and you're constantly thirsty. You're shaking your head, which sounds like you. Yeah. So that can be something you might need to see an endocrinologist about. And there's ways of testing that. The second thing is mold. If you have mold in your house, which you may not be aware of, right? Because it can be often hidden. Mold can also do the same thing in the brain, lower ADH levels. So, your blood is always concentrated, you're always peeing out water, and you need to always feel thirsty. So, I would think about those two things. So, try the electrolytes first. That doesn't work, then go see the doctor.

Thank you.

Of course. Lila, okay, Lila's coming up. Can't wait to talk to Lila. Hi, Lila.

Hello.

How are you?

I'm okay. I have a question for you. I want to know, do you crave sugar.

Because.

Because if your brain or your microbiome is unbalanced, because I. I have an addicted brain. I haven't had liquor in 34 years. I haven't had sugar or flour for four years, but I know for sure if I were to pick up anything with sugar, I would not be able. to stop eating it. I just, I can't stop eating. So I don't know if it's because of my microbiome or because it's, you know, done something to the pleasure center of my brain and won't close or.

Yeah, I love this question. And I love the idea that, you know, how do we know where our cravings and addiction comes from? Is it emotional? Is it a brain addiction? Is it coming from a microbiome? Is it something else? And I, I think, you know, I've written a book about this called the 10-day tox diet where I go into great detail about the biology of food addiction, not from an emotional perspective, but actually from a true biological perspective. So, you know, if you look at genetics, and I don't know, Lyle, if you're making a little noise here, you put yourself on mute because I hear a lot of background noise. Yeah, that's better. Thank you. So, I think if you look at the spectrum of issues, and the genetics involved. There are gene tests that we do now that look at the various genes that control craving and addiction. So there's dopamine receptors. Dopamine is the pleasure center in the brain. This gets stimulated in a lot of ways that are positive, right? But also can be stimulated through alcohol, heroin, cocaine, sugar, so for Adderall, that's what Adderall does. And so we tend to have a pleasure pain dynamic where we seek pleasure and avoid pain. So we are a pleasure seeking species and that's a good thing is you want to seek out things that are going to make you feel good and taste good and like sugar is a great thing. If you're a hunter gatherer and you found some berries, you want to eat them all right? So you could fatten up for the winter problem is we just keep eating all winter. so the dopamine receptors. And there's, there's these DR4 receptors in the brain, these dopamine receptors that, for some people, need a lot more stimulation to feel pleasure, which then drives addictive behavior. There's also a melanocortin gene, which is another Gene that regulates the melanocortin receptors, also involved in addiction craving. So we actually do genetic panels called DNA diet, which looks at some of these genes that affect your craving. I'm guessing if you had an issue, issue with alcohol in the past or addiction and craving, you you might have that. If you have that, you know it. And so you can actually say, wait a minute, you know, I know if I have a celiac gene, I shouldn't eat wheat, right? I know if I have these addictive genes, I should be avoiding addictive things. So that's, that's one category. Even if you're not having these genes and you have a diet that's high in certain substances, for example, wheat, wheat contains these, these gluten compounds, which are gluten proteins. And these proteins can get partially digested in the body, and they break down into these things called gluteomorphins, which is exactly what it sounds like. They're morphine like compounds made from gluten, and they bind to the opioid receptors in the brain, and they stimulate addiction. If you ever see a kid who's, like, been an autistic kid or something like, can you take away gluten or wheat? they go crazy. They literally will try to break into cabinets, steal food, is because of this addictive property. So wheat is another very addictive food in addition to sugar. And not just because of the starch content, that also, it's like a double whammy. So those are real significant issues. So if you are someone who tends to eat a lot of these foods, which Americans do, right? We eat about 150 pounds of sugar and 130 pounds of flour. for every person in America every year. If you do that, you are constantly stimulated, you're constantly stimulating the receptors in your brain that are going to create craving and addiction. And you, and, and, and it's, it's all, also it's really fascinating to me about this addiction is that it, it, it does, when you, when you look at how food is biologically addictive, and I have a whole textbook on this, it's not just a, sort of a fringe theory. This is a medical, well-established medical concept, even though a lot of people don't, don't buy it because they maybe haven't read the research, which I have. But what happens is the, these, these foods actually, even if they're masked, they still have the same effect. So a great study was done by a colleague of mine, Dr. David Littlewick at Harvard, where he took two groups of overweight guys, and on one day he fed him a one kind of milkshake. And on the next day he fed him a milkshake that seemed exactly the same but was quite different. And they checked what happened to their blood levels of blood sugar, insulin, you know, all kinds of stuff, their craving, hunger, and also they looked at their brain imaging. They looked at a functional MRI to see what part of the brain lit up. And what was fascinating was that even though they thought they were having the same milkshake on both days, they had profoundly different effects. Why? the milkshakes were the same in protein, carbs, fat, fiber, calories, exactly the same. The only difference was where the carbohydrate came from. One was a very slow carb, very slowly absorbed. The other was like a fast car, very quickly absorbed, like sugar. And when they had the fast carb, the sugar carb that actually they couldn't tell they were having a different kind of milkshake. They were completely different biologically. Their insulin spike, their cortisol spike, their adrenaline spike. they got hungry, their Cravings increased, they ate more. And their brain scans lit up in this area called the nucleus accumbens, which is the area of the brain that is stimulated in addiction. Right. Alcoholism, heroin, cocaine, Etc. Sugar. And it lit up and you could see it on the skin. It was really frightening. So that's. That's really a real phenomena. Then the question is, what else can cause Cravings if you're not eating it and you're okay? Well, you might have the genes, but then there might be stuff going on in your gut. and the most common thing we see is what we call CIFO, small intestinal fungal overgrowth. And people say, oh, I have candida and all that. Yes, that, that is a common thing, but it's not as common as people think. But there is a, a cluster of people who have fungal overgrowth in their gut. And when you have that, you are going to crave a lot of sugar, and it's a disturbance in your microbiome. So those people need to really starve the fungus. They need to treat them sometimes with herbs, probiotics, special probiotics. One of them is called Saccharomyces boulardii, which is a big word, but it's a very powerful probiotic that can fight yeast. Other ones are great as well. And then there's herbs that are great, like oregano and thyme and other things that can be taken. So I think, you know, it needs a comprehensive look at what's going on. I don't know if you have digestive issues or what's going on, but I think It's a really, really powerful approach and it can be extraordinary when you actually get it nailed. So I think that that's key is get your guts sorted, learn what your biology is doing, and make sure you're eating in a way to stop those cravings, which particularly is best done by eating a higher fat diet, like good fats, avocados, nuts and seeds, olive oil, avocado oil, things like that. so that's. That's what I would say about your Cravings.

Okay. What was the name of that test? Did you said some tests you can.

Oh, it's a company that makes this test called DNA diet. I think you have to order through your doctor. It's a little complicated to interpret. You might be able to get it commercially. I don't know, but it's just a cheek swab. We do it in our practice at the ultra Wellness Center, and we helps us guide our patients.

Okay.

Okay. Sounds good. Of course. All right. We have Sherry next. Hi, Sherry. How are you?

Good. How are you? I have a question. It is, are food sensitivity tests accurate and are they worth doing?

Ah, good one. Well, this is a great question. Are food sensitivity tests accurate and worth doing? this is a debate that's going on in, in functional medicine circles for decades. And, and I have, you know, the question is, this sort of depends, right? Depends on the lab, it depends how you interpret the test, it depends what they mean. I think, you know, just to sort of break down how we think about food and functional medicine, there are a lot of ways that your body can react to food, right? you can have a true allergy, like a peanut allergy or shellfish allergy, where your tongue swells up, you get asthma, you can't breathe, you go in anaphylactic shock, you die. Like that's, that's true allergy. We call it IgE. And then there are delayed responses. We call it the delayed hypersensitivity, which is IgG or IgA responses. These are more subtle. So it's not like you eat a peanut in five minutes later in the emergency room. And so you might eat you know, you might have dairy and then like a day later you get a migraine headache or you might have an egg and you might get diarrhea, you know, but you can't connect the two. It's hard to connect the two. And, and, and then there are other reactions that are intolerances, like lactose intolerance or fructose intolerance, where it's not a true allergy, but you don't tolerate it. And then there's, there's a whole sense of sensitivity to different ingredients in food. So, for example, like aspartame can cause migraines and neurologic symptoms, or MSG can cause that, you know, a Chinese food headache thing. Those are not allergies. Those are, those are related to excitotoxins. And then, and there's other things like additives and chemicals. We eat about three to five pounds of additives and chemicals every, every year per person in America. You think, oh, I don't eat that much food. How much added? When you add it all up, it's a lot. And those can cumulatively that's cumulatively be a real problem. So I I'm really adamant about never eating anything with weird junk in it, you know? I mean, someone was taking a vitamin the other day, and they're like, what is the vitamin? It's all good with iron. It looks nice. But, like, I looked at there was a titanium and red dye and yellow dye and green dye. I was like, I don't know. Why would they die? You know, it's like, make it a white pill. Who cares if it's purple, you know, or green or yellow? So then there's a testing. So it's true allergy testing, which you can do, like, skin test, or you can do IGE blood testing. Those are pretty accurate. and, and are reliable. But, but most people's sensitivities are not related to that. Very, very small. Like, probably one, two percent of allergy is that. Then there's the delayed allergies. And there's a lot of different labs that do testing, immunolabs, Genova, Cyrex. And, and so they, they, they can be very helpful in cases where, where there's a puzzle around food. And, and the, and the way I interpret them, the way I think about them, is that they're just Clues. They're not definitive and they're not allergies. their sensitivities and they will change over time if you fix the gut. And usually they're a sign of what we call leaky gut. So when your gut becomes permeable, you've got basically a layer of cells in your small intestine. It's one cell thick, but if you lay it out flat, it's the size of a tennis court. And a lot of things can screw that up, right? Our processed food diet, sugar, alcohol, stress, antibiotics, acid blockers, C-sections, lack of breastfeeding, you know, on and on and on. I've written a lot about gut busting. lifestyle that we have in gut-busting drugs. If you have that, then the gut becomes permanent, start leaking in these proteins that should be broken down. So in other words, when you eat a chicken, you don't become a chicken. We eat an apple, you don't become an apple, right? It breaks it down into the like raw materials, right? It's like if you have a house, you could take all the wood apart and you could build something else, right? That's sort of how it is when you eat. Problem is it doesn't always work that way and you can put in into your body partially digested food proteins, and they leak in and right underneath your gut is 60% of your immune system. So your immune system's like, hey, what's that? That's bad. Let's tack it. And that's what your immune system's supposed to do. But then you create these low-grade symptoms, brain fog, digestive issues, aching, fatigue, depression, insomnia, congestion, sinus issues, headaches, and just the list goes on and on. And, and those can be very vague and strange, and they're what I call FLC syndrome. That's when you feel like crap. and, and the food is usually the reason. And that's why I created the 10-day reset, which is a program to eliminate most of those common food sensitivities, reset your biology, and within 10 days, you'll know if how you're feeling is related to what you're eating. And it usually is very powerful. It's probably the best test. Actually, we call an elimination diet, but I like to call it an addition diet. We add in all the good stuff. We just take out the bad stuff. So the test can be helpful. And I like some tests more than others, but I see, for example, someone has 30 different things they're reacting to. I'm like, oh, this person just has a leaky gut. It doesn't mean they're really reactive to these, but if the ones are like four plus and high level ones, I'll tend to get rid of those and then just have them heal the gut. So it really depends on the interpretation of it and the understanding of what it means, which often, unfortunately, most people don't think, oh, I'm allergic to all these foods. I can't eat them. No, that's not how it works. you've got to fix the gut. And the real question is not what are you sensitive to, but why are you so sensitive? And how do we fix that sensitivity by rebalancing your biology, particularly your microbiome and leaky gut?

So you can fix your leaky gut without avoiding your food sensitivities?

No. You have to understand it's complicated, right? Let's say you have 30 foods, five of them are like high level reactions. Get rid of those five, fix your gut, and then don't eat a ton of the other ones, but you don't have to completely get rid of them.

So, you're not going to be able to fix your gut if you don't stay away from those food sensitivities. Yeah, typically.

And then the goal is, I mean, when I was very sick, I had a leaky gut and I couldn't eat anything. I lived on turkey and broccoli and brown rice for months, and that still was terrible. But then I learned how to fix my gut. Now I can eat anything and I'm kind of bulletproof. I mean, if I eat dairy, I get congested and some issues, but I have a little lactose intolerance. But other than that, if I eat cheaper goat, that's a little bit better. So, I've sort of learned how to fix my gut and that's what I want people to do is not live restricted lives but become more resilient and healthy so that they fix the problems that led to it in the first place.

So, do you Do you recommend doing a food sensitivity test?

It's in the context of working with your doctor, depending on what they say. And I think it can be helpful, but you have to know what you're doing.

Do you do one?

So I think we have another question from Michelle. So I'd love to talk to you forever, Sherry, but thank you so much for joining us today. Hi, Michelle.

Hi, Dr. Hyman. How are you?

Good. How are you?

I'm doing very well. Thank you. My question to you is, should we be practicing intermittent fasting? And if so, how is it done correctly?

Okay. Well, intermittent fasting is, what does that even mean? Right? I think there's so many terms thrown around intermittent fasting, time-restricted eating, fasting mimicking diets, ketogenic diets, and they all do similar things and they're all different things and I'll define all of them. So first I'll define them and then I'm gonna explain what they all do and then how to do them and which to choose. What they do is they put your body in a temporary state of starvation or a starvation like state. So whether you're ketogenic or a fasting mimicking diet, it's a starvation like state. if you eat in a, you know, a fasting mimicking diet, that, for example, is five days of extremely low calorie diet of, let's say, 800 calories. If you have ketogenic diet, that's 70% fat, it cuts out all the carbohydrates from your diet, so you burn fat instead of carbs. So it actually your body thinks it's sort of starving and you're burning up your fat stores. If you're doing time restricted eating, you might do a 12-hour fast, which is essentially what most people should do at the minimum. Like if you finish dinner at eight, you eat breakfast at eight in the morning, that's a 12 hour fast. If you eat dinner at six and you have breakfast at eight, that's a 14 hour fast. And if you eat dinner at six and have breakfast at 10, that's a 16 hour fast. So you can do 16 hour, 14 hour, 10 hour, eight hour fast. I mean, sorry, I think I would never do anything less than 12 hours. So basically 1214 or 16. And then there's intermittent fasting, true intermittent fasting, which may be a 36 hour or a 24-hour fast once a week or twice a week. So I had a patient recently who had terrible autoimmune disease and he would do a 36-hour fast once a week or sometimes even twice a week. So he would skip a whole day and then he would not eat till the night following that day. And it really helped him fix his fatty liver, it helped his autoimmune disease, can be very helpful. So what they do is they do a number of different things. one, they, they help to fix your metabolism. So they burn belly fat, they increase muscle mass, they reduce inflammation, they increase antioxidants, they increase cognitive function and brain sharpness. Because when you are starving, you want to be sharp so you can go find something to eat. It, it actually builds bone density and helps to increase stem cell production and decreases inflammation. And so many, so many you know, better, many better things that you can do for your body just really through this process. So it's kind of an exciting way we're learning about. And I think there's controversial data. There was a recent study that came out, so it wasn't as effective, but I think there was a lot of flaws in the methodology of that study. And I, and I've seen clinically, this be very effective. So it's really important. Not everybody should do it. Like, if you're pregnant or you're really sick or you're have, you know, if you're really super thin or your adrenals are shot or, you know, there's a lot of reasons it's not for everybody. but it can be something worth experimenting with. And I write a lot about it in my book, the Pegan diet, which you should get. It's coming out February 2021, which is not that far away.

We'll get it. But I, I do the, the fasting because I heard it was, that's when your body heals and your cells regenerate. And so I stop eating at eight and then I don't eat until 12 the next day.

That's right.

But I lose a lot of weight and I don't want to keep losing weight. And I just want to know if that's something that's really helping my body and should I continue it or should I just eat, you know, do it.

Well, you can, you can, you can do it a few days a week. You can do it three days a week. You can do a shorter window of 14 hours. Uh, but you're right. What happens is this process of, of autophagy, which is where you literally you clean up all the bad parts and your, it's like a recycling plant starts at night and repair plant starts at night. If you're just eating the whole time, which we do, we just eat and we eat after dinner, we eat and we get up. You're not giving your body a chance to repair and heal. So it's very important. It's great for longevity.

Okay. Well, then I should continue it. It'll help. It's healthy. It's a healthy thing to do.

Yes, thank you. And I think we have Susan up next.

Hi, Dr. Hyman. I just first wanted to say thank you. About seven years ago, your work helped me lose 80 pounds. which I have kept off for several years.

Where did you lose it? Did you find it?

No, fortunately it's gone.

Oh, good.

But my question today is about protein powders. And I was wondering if you could weigh kind of pros and cons of using them as supplements or using them occasionally as a meal replacement and what to look for if one is looking at protein powders.

Yeah, so I think, you know, there's so many protein powders on the market. Yeah. And I think you want, you know, simple is best. There's a lot of complicated ones out there. They have a lot of sugar sometimes, a lot of starch, a lot of additives, maybe stevia, maybe various sugar alcohols, they may be sources approaching that aren't that great. I mean, so I think it's really important that you look at what you're actually consuming. And there are a lot of good ones out there for sure, the ones from bone broth, there's ones from whey protein, if you're not interested in dairy, there's ones from plant proteins like pea protein, there's rice protein, there's soy protein. I stick away from, stay away from the soy protein shakes, they tend to be the isolated soy protein and that is really an industrial byproduct of making soybean oil, very bad for you, may cause cancer in animal studies, so I tend to worry about that. and so I think really, really simple proteins. And depending on what you're trying to do, you know, if you're older, you tend to need more of the branched-chain amino acids. You need more leucine and others to help build muscle. So, so animal proteins are of higher concentration. So whey is a good one. I personally like goat whey, and I, I, my personal favorite, obviously, is one that I created full disclosure. It's called the Pegan Shake. and I was so disgusted with most of the shakes out there, so I decided to create my own. And it's essentially what I want to have for breakfast. So it was very selfish, and I had it this morning, but it's basically protein, fat, and fiber, which is what you want to have for breakfast. You want to get protein, you want fat to feed your mitochondria and to stop cravings and hunger, and you want fiber to feed your microbiome. So it really is a very powerful shake, and it tastes so yummy. basically made up of organic pea protein, organic pumpkin seed protein, grass-fed collagen protein. It has avocado oil, MCT oil, which is a special kind of fat that helps to stimulate mitochondria to produce more energy to burn. It burns cleaner. It's great for your brain. It also has a little extra leucine just to bump up the leucine to the level at which you require to synthesize muscle. And it's also got acacia fiber, which is a great prebiotic fiber, which also makes you feel full, but it's great to feed the good bugs in your gut. So I love that. And I mix berries in it or I'll throw different things in it just to spice it up, but make different shakes. So it's really pretty yummy.

And is it okay to use that as a meal replacement? occasionally, I mean, not all the time.

Sure. Absolutely. I have it for breakfast most days, you know? Okay. I am, I mean, depending on what, like, if I work out, I might add a couple of scoops of goat whey in there, mix it up just so I can bump up the protein because I'm trying to, you know, I'm old now and I need to build muscle. So, me too. So, yeah, I hit 60, then I'm.

Like, all right, I better get real with this stuff. I can't just talk about it. Okay.

Thank you.

That's helpful. Thanks a lot.

Sure. All right. And we have one more guest. One more guest is Lisa Ann. Welcome, Lisa Ann. Hi.

So I have a quick question.

It's probably not a quick question, but what role does fatty liver have to do with autoimmune diseases? Okay. First of all, fatty liver in autoimmune disease is the question. And fatty liver is probably the most common problem, it affects over 90 million Americans, including little kids who are sucking back the sodas with fructose, high fructose corn syrup that just causes your liver to build and accumulate fat. Most people don't realize it's not fat that makes you have a fatty liver, it's starch and sugar. In fact, foie gras, which is means fatty liver in French, basically it sounds nice when you say foie gras, but essentially it's when you get in fancy restaurants, and it's duck liver. When they basically force feed the ducks, they put a tube down their throat and they pour corn into the tube and they force feed them so they get a fatty liver. And that's what they do. So it's not very good, not very nice for them. But, yeah, that's, we are all walking around with fatty livers and you want to have very, very low fatty liver. Why? Because it creates a lot of inflammation, causes diabetes, causes you to gain weight, causes a heart attack. causes cancer, it's just not good. And so the question you have is, and how do you fix it? You basically get rid of the starch and sugar and eat more good fats and it'll fix. And there's other things you can do as well. But the key here is to understand that autoimmune disease is an inflammatory disease. So anything that causes inflammation will make it worse. So if you are, for example, with COVID we're seeing this now, if you're overweight or obese, you're much more likely to get really sick from COVID and end up in the ICU or in the hospital because you're already inflamed. And then when the virus hits you, you're pre-inflamed and the fire takes off and you basically end up with this cascading inflammation. And the same thing can happen autoimmune disease. So I actually never had this question before. It's a great question. I probably should have looked it up before, but I didn't. So I would say that, you know, theoretically there is a large chance that fatty liver can exacerbate autoimmune disease. and I think we also know that a lot of sugar and starch in general are not great for autoimmune disease and inflammation. That will just cause inflammation in general. So, I think it's a good idea to do what you can to fix your fatty liver by basically eating a lot of good food, basically like a Pegan diet. And, I probably would feel really bad if you want to eliminate grains and beans, you want to eliminate most fruit, have basically protein, fat, lots of veggies, nuts seeds. and that will be your diet because it'll really rapidly fix it. Even MCT oil can, can be something that can fix it. Alcohol obviously can cause fatty liver. And in one study of rats, not sure how it applies to humans, but they found that, they found that when, when they were poisoning the rats with alcohol, that if they gave them just like regular oil, like whenever it didn't help, but if they gave him MCT oil, literally reverse the fatty liver even while they were poisoning them. with alcohol. So I'm not saying you should do that. What I'm saying is that, you know, there are a lot of ways you can heal a fatty liver. And I've written a lot about it. You can just Google Hyman fatty liver, and you can learn about it. How long does it normally take to kind of reverse a fatty liver if you really focus on eating clean? It depends how bad it is. Right. But, you know, let's, if you're like 400 pounds, it could take a year, right? if you are, you know, just maybe 30 pounds overweight, maybe only, you know, might only take a few months. So I think, I think it just depends and you have to follow your test. And sometimes you might not even see, they might even see a, a result on the lab work. You might need a, to do another test. There's an ultrasound test you can do. Right. The ultrasound tests a couple of years.

In a row now.

Yeah, but, you know, the key is to, is to get, get the weight off, but the weight is, is not really the issue. It's the diet. So, you know, if, if someone has fatty liver, what I tell them to do is to, you know, go, for example, if you want to really go extreme, you can go on a ketogenic diet and do intermittent fasting. So, I mean, that, that would be a very powerful way to do it. So eat, you know, skip a day of eating a week or, or even do a three-day fast sometimes. or you can do, for example.

Just.

A 16-hour fast every day and do a ketogenic diet or any combination of those things. That's going to make the most difference for you the fastest. Very good.

Thank you.

All right. Well, thank you all so much for watching. Ask Dr. Mark. That's me. I'm Dr. Mark. I love the questions. They're really awesome. You all are so great, and I wish I could answer everybody's question. But that's all we got time for today. And if you want to ask me a question in the future, all you have to do is text me, go 413-225-8995 and use the hashtag AskMark and my team might pick your question for one of our future calls and we can have a chat like we did today with so many people. If you missed the live stream, don't worry, we're going to be airing it on the Doctor's Pharmacy Podcast very soon. And thanks for joining us and we'll see you next time. on this little special episode of the Doctor's Pharmacy called Ask Mark. 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. Now back to this week's episode. Hi everyone.

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