AVOID THESE Toxic Skin Products To PREVENT DISEASE! | Mark Hyman & Dr. Cindy Geyer

Most of us put stuff on our skin every day.

There's so many things that are in our skincare products that have been dubbed endocrine disrupting chemicals.

You wouldn't eat it. You shouldn't put it on your skin. So the question is, you know, what are we using, right? What are the things we're using? And clearly there are, there's a lot of topical things we use, everything from shampoo to makeup to body care products. to make all the kind of skin care things we use like sunblock and tick repellents and insect block, insect blockers. How are these things different? Let's take sunscreen for example. This is something summertime people want to get skin cancer. They're putting on sunscreen and is it okay? What should we be doing? And how do we figure out what's going on? I mean, a lot of the sunscreens also have compounds that destroy reefs too. There's like reef damage to the coral reef. So you're only killing yourself, but you're killing the reefs.

Right. Well, there's a lot of the chemical sunscreens like Avobenzone. I don't even know all of the names of them, the chemical sunscreens. And many of those are potential endocrine disrupting chemicals as well. The flip side is, Mark, I'm one of those people who grew up in the South, had more than my share of sunburns, had my first skin cancer when I was 37. So I also want to slow down skin aging and wrinkles and skin cancer. So we kind of have to say, well, how do you get the protection? without putting yourself at risk. I personally am a real fan of the zinc and titanium, the mineral based sunscreens, or even just a hat covering your skin, staying out of the sun in the middle of the day. I mean, I think there's a lot of other things we can do that are going to be safer for us and safer for the planet. One of my favorite one-stop shopping places to learn more about safety levels and which either skincare or sunscreens contain things we do or don't want is the environmental working group. And I know you've been a big supporter of their work for years. I think they were some of the pioneers at really raising awareness. And what I love about them is they have a safe cosmetics database that you can search by type. So you could search sunscreens or you could search by brand. Plug in your favorite brand and see how it rates to others on their list.

What about the sort of things like the tick stuff? Because people are worried about ticks and DEET is really common, which is a terrible toxin that's used to kill insects, but also is a neurotoxin that can affect humans. So, they say not to touch yourself, don't put your mouth, but like putting your skin, it goes through everything. So, tell us a little bit about DEET and what to do about that.

Yeah, so that's another one. I mean, you know Mark in the Berkshires ticks are everywhere. So for those of us who love to be in the woods, you always have to be mindful of enjoying your time in the beautiful woods and hiking without putting yourself at risk for getting a tick-borne illness. So how do we navigate that balance as well? You know, for people who are super concerned, I don't know how you feel about this, but if you tuck your pants into your socks and put a little deet around where they join, maybe that's enough. I don't know. I don't do it. I mean, I hike all the time and the other nice thing about being in the Berkshires, I can come home, strip on my front porch, sleep my clothes on the outside, go in and do my tick check because I think that's probably the most important thing. The other interesting piece though is there's emerging science-based evidence that some essential oils may be almost most effective is SD at repelling ticks. There's been some research on lemon eucalyptus oil, on thyme oil, on citronella. So I think that is another reasonable option to try to get some of the tick repellent benefits without causing harm.

So those essential oils are basically plant chemicals that are repellent. And this sort of loops back to, you know, the sort of view of functional medicine, which is that plants are highly intelligent. They're in fact sentient beings, believe it or not. They have 20 different senses and they do all kinds of smart stuff that we don't really attribute to plants, but they produce these molecules to deter insects from the cells. And they communicate with other plants. So if there's a caterpillar eating a plant, that plant goes, Ooh, I'm getting eaten by a caterpillar. I'm going to produce this molecule. And by the way, I'm going to send a message to my neighboring plant friends over there. through the mycelium rhizome network that you should secrete this chemical too. And so these plants produce all these wonderful chemicals that we use, you know, for our own benefit, but they're really for their benefit. And I think the essential oils are great and there's a lot of natural alternative products out there that are for insects repellent, for skin care, for makeup. You know, you don't realize a makeup is like lead, you know, and a lot of makeup and a lot of lipstick is leaded lipstick. Yes.

Oh my gosh.

And those things are really avoidable. It's just a matter of education. And I think the beautiful thing about it as we move in the right direction, as people start to become conscious, as we push those companies by our financial choices, we actually can drive the marketplace into a better set of products. And that is really what we need to be doing. Okay, so it's a big deal to think about what you put on your skin. I remember you know, learning that basically if you wouldn't eat it, you shouldn't put it on your skin. And you and I both know that when we were in medical school, that we deliver all kinds of drugs to the skin. I mean, one of the quickest ways to get someone relief from chest pain, if they came into the emergency room with angina or, you know, heart disease, was to slap a toothpaste tube full of, like, nitroglycerin cream and put a bandage over it. And that kind of went right through the skin. We know there's hormone patches for women, there's pain patches, there's all sorts of patches that people use because the skin is a vehicle for delivering medicine. So it makes logical sense to think that we should be aware of what we're putting on our skin in terms of sunblock, insect repellent, makeup, you know, body care products, and yet most of us never give a thought about it. So tell us, Cindy, why should we really care? And I think it's, it is, you know, because this is, it seems this would be like maybe a trivial issue, but how big of an issue is this? And why should we worry or should we?

Well, I'm glad you pointed out that we absorb things through the skin. So we think we put it on our skin and it's just going to stay on the outside, but it can potentially get inside our bodies. And one of the challenges, Marc, is trying to do good research to actually prove cause and effect when you're looking at some of the carriers or preservatives that are added to the things like the cosmetics that we put on our skin. You know, our old model of what happens with toxicity is the dose makes the poison. You know, you have to have massive amounts for it to have a negative impact. But there's so many things that are in our skincare products like phthalates or parabens that have been dubbed endocrine disrupting chemicals. And what that means is even tiny amounts, especially at critical windows, may actually muck up hormonal signaling and have long lasting impacts that's less related to the dose but the cumulative exposure over time. So it's hard to tease out. You might be having exposures every day in teeny tiny amounts that don't seem immediately problematic, but down the road when you're struggling with insulin resistance or breast cancer or uterine fibroids or thyroid issues, it could be related to these endocrine-disrupting chemicals that have reaped havoc on our hormone balance.

I mean, so yes, why are all these compounds used in these products? I mean, why do we need all these petrochemical, endocrine disrupting, hormone busting, disrupting compounds? Why are they there? It's a great question.

So parabens typically are added as a preservative to extend the shelf life of your skin creams or your topical creams. Phthalates. Yeah, so parabens. So you can keep it on your shelf for a year or two and it won't smell funny or it won't go bad. And so you don't get bacteria. I mean, some of them are trying to keep contaminants out. Phthalates tend to be embedded with fragrances to make things smell pleasing to us and we put them on our bodies. And those are also endocrine-disrupting chemicals.

And is there a way to measure in the body whether there are these chemicals that are there from these products that people are using?

That's a great question, Mark. In studies that are trying to tease out how they influence our health, they often look at urinary levels to see how much people are exposed to. It's a little bit challenging, however, because it turns out that all of us show evidence of exposure to these chemicals. So it's a little bit hard to know what to do with measurements other than trying to do it from a scientific standpoint to say, do the levels track with health outcomes in clinical practice. I have not done that. I don't know if you found it helpful or not when I was first looking at it. We ended up coming back to the same recommendations anyway. We need to reduce exposure and find ways to support your body's getting rid of them.

Right.

I mean, everybody should cut out toxins from their life and everybody should do all the things they can to upregulate their biology to detoxify these compounds, for sure. But Sometimes it's really helpful. People just don't know about their exposures. I had one woman who was using a sunblock for years and her makeup, we checked her urine, super high levels of parabens. I'm like, oh, this isn't good. And other people, you have high levels of phthalates because they're drinking plastic water bottles or people have BPA because they're not aware of where it's coming from, which is best phenol A that comes from credit card receipts or restaurant receipts or just all kinds of gas station, all that stuff. It's in plastics and bottles. So I think we really, can raise awareness by seeing that it's in your system. You know, I think I find that often helpful for people to change their behavior too. It's like, and then you can actually track it and see that it's coming down and see what's happening. And I think, you know, it is a little amorphous because, you know, when you look at, you know, on an individual level, it's hard to draw the connections in a one-to-one level of whether this caused the problem or not. But if you look at a population-wide level, these toxins clearly are linked to all sorts of harmful effects in terms of endocrine disorders, heart disease, cancers, and more. And I think it really is important for people to understand what they're doing, what they're putting on their body. So the other thing, I'd love you to talk about is some of the epigenetic effects of the toxins on the fetus when the mother is exposed to the products that could cause this hormone disruptive chemicals to get in the blood of the baby?

Yeah, I think that's really important to understand that there are critical windows or critical timeframes that it's even more important to reduce exposure. And one of those classic timeframes is when a woman is pregnant. Even little bits of exposures in utero may affect the fetus and then those impacts persist into adolescence. A study a few years ago, what they did, a lot of the data has to be correlative, but they measured urinary levels of phthalates and parabens, in women at two different points in their pregnancy. And then when their babies were born, they tracked them for 9, 10, 11 years. And they found that higher levels of phthalates and parabens in the urine, the daughters of women with those higher levels ended up going into puberty earlier, which now that doesn't prove cause and effect, but you know, sometimes you can't ethically design a study. And when we see research like that, that it does correlate with endocrine challenges down the road, we have to take that seriously. We have to take that seriously. There's been some other research linking exposure in utero in particular or early childhood to phthalates and parabens to higher incidence of ADHD-like symptoms in adolescents. So even neurodevelopment. Again, a lot of the data is correlative and epidemiologic, but we can't really design a placebo-controlled double-blinded trial to willingly expose one group of women and not expose another and track their children for 20 years. Yeah.

I mean, it's linked to ADD, to neurodevelopmental issues, behavioral issues, later stage symptoms of, you know, obesity even, diabetes, heart disease, cancer. when they're exposed to these compounds in utero, which is kind of striking because I think people don't seriously think about what they're putting on their skin, but it is one of the most important things that you do every single day. Literally, you're doing besides eating, most of us put stuff on our skin every day, whether it's shampoo, whether it's face cream, whether it's makeup, whether it's sunblock, whether it's insect repellent. Like, these are things that we use a lot of in America, and, and unfortunately, they're really problematic, so. I'll say, you go, oh geez, I've been using this stuff for a while. I'm going to switch to all these other products. But what do I do to get rid of these embedded toxins? Because if we did a fat biopsy of every American, we wouldn't be too pretty. There'd be a lot of these compounds in there that are stored in there. We begin to help get them down. And we've done podcasts on detoxification, but we're not talking about like a water fast or some crazy thing. We're talking about you're supporting the body's natural built-in detox pathways. How do we do that?

You know, Mark, before we jump into that, I want to come back to something that you just said about the fat biopsy. And I know that urine levels can sometimes be really helpful at motivating people to say, oh my gosh, I need to look at this. But we have to be aware that even if they're not showing up in the urine, if we've had old exposures, they do tend to get deposited in fat, and we're not doing fat biopsies on people. I just want to point that out. So don't use an okay looking urine to say, okay, not a problem for me.

Right.

Right. For sure.

And it's been a concern as well if those are all residing as deposits in fat tissue, if somebody really rapidly loses weight and starts to mobilize all those stored toxins, it could potentially put extra burden on a lot of different processes in the body. So it's just food for thought. And you have done a lot of podcasts on detoxification and it really is coming back to the basics. I mean, how do we get rid of things? We sweat, we break a sweat by going out in the woods or exercising or sitting in a sauna. We really have to focus on optimal gut function, hot fiber dense diet, a healthy microbiome, and specific foods that support all of our detoxification pathways. We can talk about a few of those. Drinking enough water. I mean, it's really, I don't know that there is a super magic for these endocrine disrupting chemicals, except it's really important to make sure our detoxifying enzymes have the nutrients they need to do their job.

And what are those things that our body needs most of to actually get rid of these toxins?

Yeah, we need B vitamins, we need magnesium, we need these sulfur containing amino acids that are rich in foods like broccoli, kale, brussels sprouts, garlic, onions, the allium family. Antioxidant-rich foods can kind of fill the gap with some of the deeply pigmented fruits and vegetables. You know, similar theme, I think, that's come up in other areas, but those are some of the foods that are most important. Prebiotic-rich foods that can select out a healthy, robust, diverse microbiome that can also kind of if we have detoxified and mobilized things can help us get rid of it and clear it out of our system.

No, it's the thing, other practices that we can do to help our detox system like saunas, exercise, drainage, and infrared saunas, hot and cold therapy, all those things help mobilize toxins from our system. Right.

Do you have any favorites yourself?

Do I have any favorites? I I do have.

A lot of.

Things that I do to actually mobilize my toxins every day. I make sure that I eat brassicas every day. So last night we had a big bunch of broccoli rabe for that night. We had brussels sprouts, lots of garlic and onions. I use a lot of spices in my cooking. And I also make sure I do saunas. I do ice baths. I sweat. I actually like to sweat a lot. So my exercise is great. Yoga is great for lymphatic drainage, getting massages, it's great to mobilize tissue, lymph stores. So there's a lot of techniques you can use to actually help. And then I take the right supplements. I make sure I take a cocktail because I've had mercury poisoning. I have weak detox enzymes. I take N-acetyl cysteine. I take all the methylation vitamins. I take a lot of the things that actually help to mobilize these toxins, even the sulforaphane, boosting compounds. I even use indole-3-carbinol-methane as a way of sort of helping with some of the effects on hormone metabolism. So, I'm sort of pretty fanatic about it because I've been so sick from being toxic and I don't want to be toxic anymore. But, the truth is it's hard. I didn't stop eating fish and I got my mercury levels down years and years ago from almost 200 to you know, eight or five.

Wow.

And I was like, oh, you know, it's been a bunch of years, and I've been sort of a little bit lazy about fish. I don't eat tuna, I don't eat swordfish, but occasionally, occasionally, I'll have a piece of tuna when I go out. Occasionally, and I'll eat hell of it. I never read swordfish. Occasionally, I'll have, you know, more fish.

Than I would think.

And I said, oh, I'm good. But I just checked my levels, and I, again, my level was super high. I have, like, 37 on a challenge test. Wow. You know, like, I think we're just, we're just in such a toxic world, and.

It's hard.

It's hard. I mean, last night I made a delicious, you know, Spanishy kind of Greek baked cod with tomato sauce, but like cod is not terrible. It's not the worst, but it's definitely got mercury. And I'm just like, oh, what am I doing? Like, what are you gonna eat? You know, so I've come to believe that, you know, grass-fed regenerative meat or wild meat is probably the safest protein on the planet. I know it's maybe controversial to say that, but, you know, even, you know, even you've got, unless you've got really well, grown whole grains and beans that are generally raised and have no glyphosate spray in them and are not, you know, genetically altered. I mean, there's, like, a lot of messy stuff in the plant world, so I don't know. But I, I definitely make sure I up regulate my system all the time. You want to know my secrets for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's picks, where I share my favorite tips for health, longevity, well-being and lots more. Check it out and the link below.

You know, Mark, you raise an interesting point as well. I think everybody is different in terms of their genetic predisposition to handle a given amount of exposure or not. It's not that we're just going to let, okay, you're a good detoxifier, you can let yourself do whatever. But I think that's also an important point that some people need more support than others. We all want to reduce burden. We want to reduce what's coming in. But some of us have to go the extra step and really do more aggressive programs like you're doing.

Absolutely. Absolutely. And so, you know, the good news is that you don't have to be exposed to these things by all of your typical skincare products. That you should be aware of it. That you should seek out sources of your favorite products that are alternatives to the Environmental Working Group resources at ewg.org, that you should eat Brussels sprouts every day, or at least some kind of Brussels sprouts because it makes you have plenty of garlic. make sure you sweat, make sure that you're, you know, especially even, you know, when you think about what's going through your scene, what are you touching? Like, I, I'm so aware of, like, when I, when people say, do you want a receipt? I'm like, no, thanks. Like, no thanks. Email, text me the receipt. Do not give me the receipt because I don't want to touch that. It's full of BPA, bisphenol A, which.

Has all these endocrine disrupting aspects to it. So, you know, Mark, that might have been one of the positive things about the pandemic when people were afraid of any kind of paper passing hands. A lot of people got rid of their paper receipts, a lot of manufacturers got rid of their paper receipts. I think that's a good thing.

Yeah. Oh boy. So I think we're in this interesting moment where we have a possibility of really changing our lifestyle, changing our exposure, changing our choices, and really making a big difference. And so people listening, I think it's important to be really aware of what you put on your skin. Just remember, whatever you put on your skin, you should be able to eat. that should be edible because it's going into your bloodstream directly. It's going to affect your biology in a real way. So I really encourage you to just make sure you pay attention to that and not break down all the systems.

All right, so tell us a little bit about the scope of this problem and some of the background that we know about how we think about it in traditional medicine and how we approach it versus how we might approach it using a functional medicine approach and how we deal with it here at the Ultra Wellness Center.

Absolutely, I mean acne is the number one skin condition in the United States. So it's the number one issue that people in the United States are dealing with in terms of their skin. As you mentioned, 50 million Americans are dealing with this. And you know, we know that it's more common in our, when we're going through puberty, when our hormones are shifting, we often will see acne in the adolescent age group, but we're seeing more and more acne in adults now as well. and that is definitely increasing. I remember I was having a conversation with my daughter about skincare products and okay, what's the best thing to use for my skin? And all of a sudden I realized even though she'd lived with me her whole life, I don't think I ever said this, I said, what you're eating is so much more important than what you're putting on your skin. You know, the food that you're putting in your mouth is so much more important than what topical things you're putting on your skin. And so it made us start to have this conversation, which I thought I was saying all the time, but that I think sometimes people don't realize or understand or the connection is not made, that how important what you're choosing to eat every minute of the day, how much that impacts your skin.

Yeah, I mean the traditional medicine focuses on the outside in. What stuff you can slather on your face, what creams, potions, lotions, or maybe taking antibiotics, which is a whole problem we're going to talk about in a minute. But most of our skin health comes from the inside out. So if you want great skin, if you want glowing skin, if you want clear skin, if you want to get rid of your acne, if you want to get rid of your eczema, if you want to get rid of your psoriasis, if you want to get rid of rosacea, all these things come from the inside out. And traditional dermatology focuses on the outside in. And it doesn't really work that well most of the time, even when you.

Work on the outside in.

And it's difficult, it's expensive, these medications are absorbed. You know, you basically, my rule is if you wouldn't eat it, you shouldn't put it on your skin.

And a lot of times with the topical treatments, whether it's, you know, steroids for eczema or topical antibiotics for acne, they can work in the short term, but in the long term, they disrupt, they disrupt your skin and make you more prone to getting it in the future. For example, we know both topical steroids and topical antibiotics are going to get rid of that really important layer of good bacteria that's on our skin.

So, wait, you have a microbiome on your skin as well?

No, it's kind of cool, right? Not only in our digestive system but lining our skin. And so those medications, though they can be helpful in the short term, in the long term, they're damaging. They're getting rid of all of those good bacteria which are really important first line of defense. And so then you create a dysbiosis or an imbalance in the good and bad bacteria on your skin, and then that just makes you more prone to getting more acne in the future. So it may be okay in the short term, but it's not getting to that underlying root cause.

It's true. And so we put on antibiotics on the skin. We put on these agents that dry it out like benzoyl peroxide, which are most of these acne products. and if that doesn't work, we give people oral antibiotics, which not only disrupts the facial microbiome, but also the gut microbiome. And what we know now in functional medicine and in medicine in general, if people paid attention to the research on acne, is a lot of it starts in the gut. So if I see someone with skin problems, the first thing I think of is what's going on in their gut? What's going on with their food that they're eating? With inflammatory foods, with food sensitivities, with foods that trigger hormonal responses, with foods that increase something called insulin resistance. So tell us about the pathology and the pathophysiology of acne because it's very interesting because we often just think it's like a topical thing but it's really not.

Yeah, I mean one of the things we know with foods is that when you eat foods that are really refined and processed, foods that are high in sugar and refined carbohydrates, you'll get a spike in your blood sugar. and you'll often get that spike in insulin after you get a spike in blood sugar, right? So you eat food, your blood sugar goes up, the body makes a lot of insulin, and that spike in insulin and blood sugar will cause a follicular hyperkeratosis.

Wow, that's a big word.

I know. Which just means that there's extra, in the follicles of the skin, the skin's not turning over as well as it should. should. And so cells get stuck in the skin and then those stuck cells can get more inflamed and you can get acne can get produced. So one of the major things we always start with is pulling away the refined and processed foods and the sugary foods. And starchy foods. And starchy foods, right? Anything that's going to cause that insulin spike, you can really see signs of insulin resistance on the skin in so many different ways. It's like pre-diabetes, right?

It's like you can make sure your blood sugar goes up, your insulin goes up and it creates a deficiency cycle we've talked about so much, which is this pre-diabetes that affects one out of every two Americans.

Yes. Right. Right.

And so their insulin is higher than somebody who doesn't have insulin resistance. And that high level of insulin causes a lot of shifts in the skin. It causes that follicular hyperkeratosis that causes the acne. It can cause more skin tags. It can cause something called acanthosis nigricans, which is this darkening of the skin folds like in your neck and in your armpit. And so you can, by just examining somebody right away, you can get a sense of do they have insulin resistance or that pre-diabetes state because it shifts the growth factors, the high inflammation from eating these high sugary foods causes changes in your skin.

We know that, for example, PCOS, which is polycystic ovarian syndrome, it's a common condition that affects women that causes fertility. We're going to talk about that on another podcast. It causes acne. It causes really screwed up menstrual cycles and it causes hair growth. And we think of it as a ovarian problem. It's not. It's a mouth problem. It's a fork problem. It's a dietary problem.

Often, yeah.

And so it's caused by insulin resistance. And the consequences of that are the acne and all these screw up hormones so when women have a lot of sugar, it actually can increase their testosterone, which causes acne, and it causes hair growth, and it causes infertility. So the treatment isn't heavy duty drugs and hormones, it's actually changing your diet.

Which is amazing to see. I mean, we know that when we pull away those refined and processed foods and the sugary foods, most of our patients, so many of our patients see great improvement in their acne right away. Right away.

So sugar, starch, processed foods, they gotta go. And then there's another food that is really common in this country and it is a huge driver of acne.

Yeah, the dairy.

Yeah, yeah.

Dairy.

Dairy. I mean, 'cause dairy is, you know, all of our dairy food, our milk, our cheese, our ice cream, you know, all of that is very high in hormones.

There's 60 different hormones in milk. and these are not added like growth hormone. These are just naturally occurring hormones.

Why?

It's a growth food for calves. It helps the calves. It helps the calves, right?

So it's got a lot of factors that are hormonally active that drive growth. Yes, and we know that those growth factors can stimulate acne in some people. You know, not everybody, but for some people, they're more sensitive to them and.

They definitely will cause more acne. Actually, I'm one of them. I'm one of them. If I have dairy, I get pimples. So, if I know I'm going on a TV, I can't eat dairy. I don't usually eat dairy, but I have sheep or goat, it's a little different. It's not as inflammatory for some reason. But if I have regular dairy, you.

Can count on me getting pimples. And I'm like 60 years old to get pimples from dairy. Absolutely. And I think it depends, like the question of sheep or goat, I think it depends on the person. There's some people that it really, all types of dairy bother their skin and for other people, there's some that is better than others. And what we know is sometimes the testing, like the food allergy testing or food sensitivity testing, doesn't always pick it up. I mean, we do it often, but there are times when we get a negative test result, but even if we still pull it away and people's skin improves. So, this isn't like an allergy necessarily.

Not necessarily.

It could be, like you said, all the hormones in dairy too.

But there's another category of things, which are food sensitivities that do drive inflammation and drive leaky gut and can drive acne that are independent. So, we've got sugar, we've got dairy, and we've got this other category which is sort of more amorphous, but it is a factor in a lot of people.

Absolutely, absolutely. So, there's so many ways, and I always say this, there's so many ways that somebody can react to food, right? You can have, and people get confused all the time because they get one negative report and they say, oh, then I must be fine to eat that food, right? You can get an immediate reaction to food or an IgE, you can get a delayed reaction to food or an IgG, but you can also have a food intolerance. There's just so many ways you can react to food. So just because you have one negative food test result doesn't necessarily mean that food is not causing you problems.

That's a whole other topic, which is what are the many ways that we react to food? You know, the 50 ways I love you, it's like what are the 50 ways you react to food? And it's all kinds of stuff from tartaric acid, which is a dye that causes it. with asthma, it's an additive, or whether it's MSG that can cause an amino acid related cognitive effect, or whether it's food make, or whether it's something like high fructose corn syrup, which people can have fructose intolerance.

Right.

Or how food changes your microbiome and then that changes the inflammation. I mean, there's the, you know, that's.

Yeah, by the way, in this age of COVID and coronavirus, it's really clear that the more sugar we eat, it affects our immune system, but it also affects our microbiome. And our gut health, turns out, is incredibly important for us to be resistant to the flu through many, many research studies and likely to coronavirus as well.

Absolutely, absolutely. And, you know, I think that this first case that we were going to talk about, this 22-year-old who came to see me, you know, she, it really kind of pulls in the importance of the microbiome in terms of your immune system, but also in terms of your skin. She was a 22-year-old and she started to develop acne when she was around 12. When we got more history from her, I realized she had had multiple antibiotics as a kid. She had chronic ear infections and especially when she was getting those ear infections, they were treating most of them with antibiotics. I think we've kind of calmed down a lot on treating every ear infection with antibiotics. she got a lot of antibiotics because of her ear infections.

I was a family doctor, remember? It's like, oh, give 'em out like candy, a little MoxiCillin, this and that.

It's like nothing.

Right, right.

Now I'm like horrified by what I did 30 years ago.

So she's, you know, she came in to see us because she was using a lot of different topical treatments. She was also taking a low dose antibiotic and her skin was better, but she didn't want to stay on these antibiotics and she wanted to really look at it a different way. stopped taking the oral antibiotic, which she realized she didn't want to be on forever, her acne started to get worse again. So she said, okay, I really want.

To figure out- which is not uncommon. And then doctors say, oh, you need more antibiotics.

It's like, that's the vicious cycle. It becomes a vicious cycle. We see these vicious cycles all the time with medications, right? Because they're shifting because those antibiotics, as we've mentioned, are shifting the microbiome. They're shifting the microbiome in your gut. They're shifting it on your skin. They're getting rid of that first line of defense. And then they're allowing then it's more common to get the acne again when you stop them. And so just because of her history of all of those antibiotics as a kid and being on the antibiotics and because she started we got more information. She was having a lot of digestive issues. She was having some bloating, some diarrhea, her digestion was off.

And your dermatologist never was like, what's going on with your gut, right?

No, right. No, he didn't ask that. So because of that, I said, you know what? I really need to focus on the microbiome here for this woman to help improve her acne. And so we did a stool test, which is kind of a neat way to get a sense of what's going on in the microbiome. It looks for real- How is this.

Different than like what a traditional doctor would do with a regular stool test.

You know, it looks at a lot of different biomarkers, right? So it's looking at all of your levels of commensal bacteria, like all the good bacteria and is there an imbalance in the good and bad bacteria? So it does look for acute infections, for real infections as well, but it also is really paying attention to something we call dysbiosis, which is an imbalance in the good and bad bacteria and trying to get a sense of is there an overgrowth of not good bacteria or not good yeast or parasites? It also looks at parasites. It looks at digestion and absorption and inflammatory markers.

So you look at your enzymes are working and are you digesting your food or are you absorbing your food? Is there inflammation in there? It's like a window into a dark world, you know? And we can learn so much from that through these tests which are really not available through traditional doctors. I mean, they could order them if they wanted to, but it's just not something we're trained in, which is how do we take a deep look in the gut? We were talking about the microbiome, microbiome, but it's some future state of medicine will somehow figure out what to do with it. Well, we've been doing this for 30 years in functional medicine. And now we understand even more than we ever did, and we're learning better and better how to actually optimize the microbiome and fix the problems of leaky gut and all these things that happen as a result of your patient who had all these antibiotics and this crappy diet. and developed overgrowth of bacteria that you found in yeast.

Right, so when the stool test came back, we found that there was this overgrowth of unwanted bacteria and there was an overgrowth of unwanted yeast. And yeah, and so we can do tests like you said on is there increased intestinal permeability or leaky gut? And she of course had that because of these imbalances and the inflammation going on in her digestive system. Because we know that those imbalances cause inflammation. And we know inflammation causes all sorts of things, including acne, right? So we said, okay, we need to work to fix. We need to work to fix this imbalance. Let's work to rebalance the bacteria in her gut. And so for her, she wanted to use an herbal approach and I agreed with that. So we put her on a combination of a couple different herbs that can work to get rid of the overgrowth of bacteria and yeast. and that worked really well. The one thing I always say about skin though is you kind of have to be patient sometimes. So if you are pulling away a food like dairy, which we did with her, we took her off of dairy. We took away a lot of added sugar. If you're adding in something to treat the dysbiosis, and we also gave her a lot of probiotics too, you got to give it some time for the skin to improve. you might see some improvement in the inflammatory acne right away, but for the skin to really improve, it takes like six weeks for the skin to turn over. So you wanna give it some, we always give it some time to say, okay, how is this improving? And so, and we also added in some nutrients that are really important for skin turnover. So we know that zinc and vitamin A are really critical nutrients to help the skin turn over so you don't get so much of that hyperkeratosis, that elevated levels of the skin not turning over which can cause more acne to develop.

Accutane is a derivative of vitamin A, which is actually what is used for really bad acne. And by using this comprehensive approach we use in functional medicine that we do here at the Ultra Wellness Center with the deep diagnostics we do, and knowing how to optimize function of your skin, of your gut, et cetera. We can get people better where often they don't get better and do it in a way that not only improves their skin but improves their overall health.

So, very powerful. So we put her on some zinc and vitamin A. Now, both of those, I just want to caution listeners, if you're not working with the doctor, both of those you can get too much of and they can cause imbalances in other vitamins and vitamin A is fat soluble. So, you have to, if you're going to use a high dose. There's OD on it. Yeah, you know, like I use 10,000 I use per day with her.

A vitamin A. A vitamin A.

You don't want to be on that for like a long long time. No, we did it for like three months and then we started to spread it out and I was monitoring her levels. And the same thing with zinc, you just have to be a little bit cautious of just taking a lot of this on your own because it can throw off some of your vitamin levels or vitamin A can be toxic at high doses. but it really helped. I mean, the whole comprehensive approach really helped her skin improve. And she was able to stop using both the oral antibiotics as the topical antibiotics. She was able to get off of them. And her skin, that dysbiosis started to rebalance and she wasn't getting all the acne all the time.

And I bet there were a lot of great side effects too. I bet she lost weight and had more energy and felt better.

Absolutely.

Yeah, instead of the side effects being all bad, they're all good. That's true. Just to recap, this is a really important case because it's a story we hear over and over and over again. You see someone who early on had probably sensitivities to food or maybe had antibiotics for an ear infection, and then it's this vicious cycle of things that disrupt the gut that then lead to secondary problems down the road like acne, and they lead to imbalances in the microbiome that can get treated with more antibiotics, and you're in this vicious loop, and functional medicine takes you out of that loop. and we do, you know, a very deep history and we look at also tests which are really different from what your traditional doctor will do. Food sensitivity testing, stool testing. We look at nutrient levels. We can look at vitamin A, zinc, fish oil, omega-3s that are really important. And then we have a comprehensive approach, which is dietary. We take people off food sensitivity like dairy, which is a trigger, sugar and starch, maybe other foods. Gluten can be an issue for some people. And then we rebalance the gut. I call it the weeding seeding and feeding program. We weed out the bad guys, we seed with the good guys, the probiotics, we feed them, right, which is with prebiotics and the right nutrients, like you said, for the gut healing. And we see these remarkable turnarounds in a very short time and it's not that hard. You just have to know what to do. So it reminds me of that joke where this doctor sent his patient a bill for taking his appendix out and the patient got the bill, said it's $1,000. and the patient writes back to the doctor, says, Doctor, that's a lot of money for such a simple operation. He's like, you,'re right. Sends him a new bill, says, Taking out your appendix, $1. Knowing that's what needs to be taken out, $999. And I think that's sort of the key of functional medicine. It's not necessarily that hard.

It's just knowing what to do and what questions to ask and what tests to do and what treatments to apply. Because everybody's an individual.

Yeah.

Right.

I mean, I think that's so, so key.

Right?

So we're all individuals. so that for that patient, it was her microbiome that we needed to rebalance. But for the next person we're gonna talk about, it's gonna be how do we help support their detoxification system? And for somebody else, it may be just as simple as they're eating too much sugar. But I think it's important that we have to recognize that we're all individuals. And the cause of acne is not just one problem. It depends on your individual story, how we treat it.

That's really important. We often say medicine that one disease can have many causes and one cause can create many diseases. So, acne can have many, many different things. There are common patterns and there are common patterns, so we know what to look for. But in each individual, it might be a little bit different and that's what we call personalized medicine, precision medicine, personalized nutrition, precision nutrition, personalized health, precision health. It's what we do. That's what functional medicine is. Tell us about the next one because.

It'S quite a different kind of case that you wouldn't expect.

Back that we relate to acne.

Right, so she was a 44-year-old woman and she had been struggling with acne her whole life. It got worse definitely before her period, so there was a hormonal connection. But she always had some acne and we did an elimination diet with her. She had tried some on her own, but then when she came to see us, we became more strict and we pulled away really more inflammatory foods just to see. We did some testing and we pulled away gluten and dairy and and all the sugars and refined products and her skin got a little bit better, but only a little bit better. And we did some of the stool testing on her and it looked pretty good. So I started to think, okay, we've got to look a little deeper here. And so we did some evaluation on her toxic load, right? We started to look at her how she metabolized her hormones, we started to look at what levels of toxins she had in her body. We looked at things like the pesticide levels, we looked at BPA levels, we looked at- that's BPA. BPA is a bisphenol A. Bisphenol A. Sorry. What is it used for? I'm sorry, I don't know. People get that from the hard plastic.

Hard plastic, also your credit card receipts, your ATM receipts, your- It's lining of cans. your receipts from your gas station, lining of cans. Lining of cans. People say, you wanna receive?

I'm like, nope. Yeah, no, I always say no.

No thanks.

I always say no. And then, you know, in a lot of the big containers of water that people get, those are BPA containing containers. So, you know, you wanna be drinking out of glass and, you know.

Metal.

Metal, not plastic, right? But that can act as an, it's a xenoestrogen, so it can act as an estrogen in the body.

So, it's interesting you just said something powerful. I want to just stop for a minute because most people don't realize, I think these toxins are poisons, they get that, but they don't realize that the way they act in the body is hormonal. They're hormonal imposters, mimics. In fact, there's a book I read years ago called Our Stolen Future by Theo Colborn, where she documented the ways in which all these environmental chemicals were affecting the reproductive health of animals and humans and was just fascinating to me. me and it was just like, whoa. People really want to learn about this, they should check out that book, but.

Tell us more about how that works. So they realized that BPA was an issue back in the 1970s, I think, at Tufts University, where they were doing research on breast cancer. And then they realized that the test tube was impacting their results. And then they were like, okay, we've got to figure out what's in the test tube. And that's when they realized the BPA can act like estrogen in the and impact the growth of cancer that they were evaluating or studying. And that's when we started to learn more about BPA and how it can act as a xenoestrogen or it is a xenoestrogen which can bind to the estrogen receptor in your body and then shift your hormones.

What's so fascinating about the xenoestrogens or xeno hormones is, I mean, xeno means foreign, right?

Yep.

Is that they're in small concentrations, but it turns out that they're synergistic. So we might get a little BPA here and a little phthalate there and a little whatever there. And they're not 1 plus 1 equals 2, they're 1 plus times 1 equals 1,000. And so in very small amounts, they're extremely potent and they bind to the receptors, they can activate them, they link to cancer, they're linked to insulin resistance and obesity. So BPA can cause obesity and insulin resistance. so you get these double mechanisms of insulin resistance, of hormonal disruption, and this can cause all kinds of problems, including acne.

Yeah, and so what I realized with all of her testing is that she had a high toxic load, just what you're saying. She had a little bit of a little too high of lead and mercury, her BPA was high, some of her pesticide levels were high, and she had a high level of oxidative stress. So oxidative stress stress is a marker. There's multiple different markers of oxidative stress. Yeah, there are excessive free radicals in the body. So when you don't have enough antioxidants or if your body is producing too many pro-oxidants because of poor diet or toxins, you get this imbalance. You don't have enough of the good antioxidants to get rid of the too many of the pro-oxidants that are being formed. You get an imbalance called oxidative stress. and we can measure that.

And we can see it like it's something people know, when your apple turns brown, that's air and oxygen interacting, or in a car rust, right? Or your skin wrinkles from the sun.

That's all oxidative stress, but it's happening on the inside. Yes, and you know, we always make these free radicals, but the problem is when you make too many or you don't have enough of the antioxidants or those phytonutrients to get rid of all the too many pro-oxidants. And so you can measure that imbalance. You can look at markers of oxidation, oxidative stress in somebody's body, which is associated with aging and illness.

That's an unusual test we do in functional medicine. We do here at the Ultra Wellness.

Center that you normally wouldn't get that tells you sort of what's going on. And it's a great way, I think it's one of the best biomarkers to look at to see how is somebody improving, right? And so for her, she had this elevated level of oxidative stress and I'm like, well, that's interesting. And so then we started, that's when we looked at all these toxins because they can be a cause of oxidative stress. There's multiple causes, but these can be one of them. And so I realized she had this elevated toxic load. She had some genes that made it harder for her to produce glutathione, which is this amazing antioxidant for the body.

And that's another thing we do here. We do testing that looks at genes. Now we don't do your entire genome sequence, which is a thousand bucks. But we look at very specific genes that are common, that we can do something about, that have some kind of clinical relevance.

Yes.

And that we can modify through diet, lifestyle, supplements, reducing toxic load, whatever. And what were the things you found in her?

Right, so she had a couple variations in some of her glutathione genes. Her glutathione genes, the GSTM1 gene that helps the body with production of glutathione.

What is glutathione?

Glutathione is this amazing antioxidant and detoxifier in the body. And so she genetically had a harder time with production and utilization of her glutathione.

By the way, I wrote an article years ago, it's called the Mother of All Antioxidants, Glutathione.

So if you want to learn more about it, you can check that out. And you know it, and it's still so relevant and so important. We know that glutathione is critical for a well-working immune system. We know it's critical for helping your body detoxify. And there's some of us that have.

Some variations in our genes that make it a little harder for us to make and produce glutathione.

And I'm one of them, and that's why I got mercury toxicity.

And that's maybe why you got breast cancer, right?

Yeah.

So, but there are things we can all do. So there's a lot of people with these genetic variations. So it's not like the population. Yeah, so it's not like it's a rare thing, but there are things we can do to help our body make more glutathione. And one of those things is eating a lot of cruciferous vegetables, the broccoli, cauliflower, cabbage, radish, kale, all those great cruciferous vegetables that help the body with production of glutathione. We can also give things like N-acetylcysteine or NAC, which helps the body make glutathione.

It turns out that may be helpful in coronavirus and COVID-19, the N-acetylcysteine, because it helps with the antioxidant protection and with glutathione production, which is really important.

As an anti-inflammatory as well as a detoxifier and antioxidant. Yeah, and there's been some studies that.

It can work as an antiviral and it's got some good lung effects. So, it's really an interesting new study. It's actually what we give people. who have terrible lung asthma symptoms, we literally can give them inhaled mucamist, right? Yes, which you see. It's actually N-acetyl cysteine. When we were working as doctors, I was in the emergency room, I didn't know it was a supplement. I thought it was a drug. It was called mucamist and you'd order.

It and people would get this inhaled N-acetyl cysteine for their respiratory issues. Yeah, yeah. And the sulfur containing vegetables, onions, garlic, shallots, you know, those things are really important to help the body make glutathione. And then we actually just gave her glutathione. You know, I gave her this liposomal glutathione. You can squirt in your mouth, it gets absorbed through the cheek. You can also give IV glutathione. We do that here also at the Ultra Wellness Center. There's other IVs that we do for the skin too, which is kind of interesting, you know, zinc and B vitamins. So, but the, you know, what was great was that's really what helped her skin improve, was really focusing, of course we did the good diet and the good microbiome protection, but really helping her with her detoxification.

Decrease her total body load of toxins.

Exactly, decreasing her total body load of toxins and helping her body detoxify. That also helped her body detoxify her hormones and metabolize her hormones. You always focus on those good things with detoxification. hydration too, right? Drinking lots of water, having regular bowel movements, eating a lot of fiber, sweating, exercise movement, sauna, all help the body detoxify. But for her, that's when we started.

To see improvement in her skin. So this seemed like a really different kind of approach than you'd get at traditional doctor. You go in, you go, well, I have acne, take this stuff, put it on your skin. You're saying, wait a minute, what could be the cause? The typical things aren't working, dairy and sugar elimination. So you went deeper and you said, well, maybe there's environmental toxins, so you looked at tests that helped her identify what was going on, heavy metals, petrochemical byproducts we call persistent organic pollutants, BPA and pesticides. And then you helped her with diet to actually upregulate these pathways that actually helped her detoxify. You reduced her load by identifying where these sources were in her environment, her diet, and her lifestyle, and got rid of those. And Environmental Working Group, or ewg.org, has a great list of resources of how you reduce your exposures, whether it's household cleaning products, skin products, your diet, vegetables, animal products, whatever you're doing, how do you reduce your body burden of toxins? And then you gave her certain supplements that helped to upregulate the bright pathways.

And the result was her acne got better.

It's phenomenal. That is such a different approach you wouldn't normally see when you go to.

The doctor and dermatologist and they have pimples. Yeah, because I think that the way that we're trained in conventional medicine is to quickly identify and then find the medication to suppress the illness or the symptoms. And we all know that works well in acute care. When somebody has an acute issue, you want to be able to quickly identify and suppress the issue. But with chronic issues, we know that that way of treating is not the best. But that's how we were all trained. in conventional medicine, you were trained with that same model. So we have to work to change that because we know for chronic issues and things even like acne, that just doesn't, it's not getting to that underlying root cause.

See, that's the thing. The doctor gives you a label. Oh, you've got these little white things on your face or it's inflamed. I know what you got. You got acne. But acne isn't the cause of the problem. It's the name of the problem. Yes. So in functional medicine, we focus on the cause, not just the name.

Absolutely.

It's important to know what it is, but acne rosacea is another kind of acne, which is really problematic. A lot of people have it. It's like where they get red nose and red face, and that often is treated in a similar way. The gut is a huge factor.

It's such a huge factor, the gut. I mean, I have patients where it's dysbiosis until proven otherwise. You see so much of it is dysbiosis, and we treat the dysbiosis, the acne rosacea gets better. And when it starts to come back.

We go, okay, that dysbiosis is coming back. So Liz, this is an incredible podcast. I think it's going to help so many people who suffer with skin problems. Not just acne, but like all skin problems. And we talked about some other ones on other podcasts. But this is the problem that affects 50 million people. And like I said, that's more people that have cancer, diabetes, and heart disease, right? Autoimmune disease affects more people. But that means all the autoimmune disease. So this is such a common issue. It's so poorly treated with traditional medicine in ways that are actually harmful, like oral antibiotics or accutane can be hard on the liver. And that it's relatively simple to treat using functional medicine, using a different set of questions, a different set of tests, a different set of dietary interventions, specific supplements that can help. We talked about things like zinc and vitamin A, fish oil, evening primrose oil.

Is another one so it's just such.

A refreshing story to hear of these patients who recovered from a problem that creates so much problem for people. It creates so much emotional distress, you know, it creates so much psychological distress and it's just a pain to have pimples. So I just really grateful for the work you do and work we do here at the UlTrewana Center to bring these kinds of approaches to so many people. who really are struggling. Hey YouTube, if you like this video, you're gonna love the next one.

Click on it to check it out today. Small intestinal bacterial overgrowth is also one.

Of the triggers for rosacea.

A lot of patients that you see with rosacea will have irritable bowel type symptoms or bloating type symptoms. And when you do some testing for that and you treat it, that oftentimes will clear up their.