Exclusive Dr. Hyman+ Ask Mark Anything: Increasing Metabolism, Anxiety, And More

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Hi everyone, welcome to another episode of Ask Mark Anything. My name is Harshil Parth and I'm the Dr. Hyman Plus Community Manager. and I'm joined by Darcy Gross, the producer of the Longevity Roadmap docuseries.

Hi, Darcy.

And of course, we're here with Dr. Mark Hyman. Hi, Dr. Hyman.

Hi.

Well, welcome, everybody. So we gathered all of your questions this month, and we're ready to ask Mark anything. So let's go ahead and get started. So the first question, Dr. Hyman, is all about increasing your metabolism. What's the best way to increase your metabolism? Should you be calorie restricting? Should you keep it under 1,000 calories? how would somebody go about doing that?

Well, that would be the worst idea you could possibly do. If you eat 1000 calories, your body's like, I'm not getting any food. I better shut down the system and slow down and go into hibernation mode and conserve calories. So you're not going to lose weight by restricting calories for a long period of time. You obviously will initially, but then, you know, your metabolism will slow down and you'll, you'll be in trouble. so what is metabolism anyway? Because that is a big question. And what is metabolism? Well, it's really something people, I think, misunderstand. It's essentially a simple phenomena of how much calories you can burn or how many calories you can burn per minute, which is limited by how many liters of oxygen you can burn per minute. So essentially you take calories in and breathe in and they are combusted or burned in your mitochondria, which are the little energy factories that you have in every cell, and there's hundreds to thousands and thousands of them. And they're essentially your metabolism. So the slower they work, the slower your metabolism, the faster they work, the faster your metabolism. And the question is, what do you do to improve your metabolic state? How do you improve your, your mitochondrial function? And, and then what is the cause of poor mitochondrial function? So let's just go into what is the cause of poor mitochondrial function. We'll talk about it. and metabolism and how do we fix your mitochondrial function and metabolism? Sound good? So here we go. So the things that really affect your energy metabolism are your diet and obviously exercise. The diet part is interesting because what causes poor metabolism is essentially something we call insulin resistance. We've talked about it a lot. But essentially this phenomena where our bodies become resistant to the effects of insulin. So every time we eat something with starch or sugar, we get a bump insulin in our blood. And over time, if we eat too much starch and sugar, that insulin just goes higher and higher and higher because it stops working because the cells don't listen to the insulin signals and they just keep the sugar and the calories out in your bloodstream. And that's not a good thing. So you end up end up having more and more insulin, which makes you gain weight, it slows your metabolism, it causes inflammation, it makes you hungry, all of which are disasters when it comes to trying to lose weight or increase your metabolism. So that's really the biggest phenomena, which is too much starch and sugar. We need about probably a pound, almost a pound a day combined of starch and sugar per person, about 152 pounds of sugar and about 133 pounds of flour per person per year. That's about a pound a day. So that's going to screw up your system. Our bodies are just not adapted to it. We never had these refined flours. In fact, we didn't have flour mills, proper flour mills to have refined grains until the 1800s. And the way they figured out that It was vitamin deficiencies because they actually were feeding the prisoners the white flour and they were giving them the kind of grain stuff that they took off to the chickens and the prisoners starting to get very sick. So they actually began to realize there was something lacking. So white flour is terrible and sugar is just nasty. It really drives all these metabolic processes. The other thing that can affect your metabolism are things like environmental toxins. They're basically mitochondrial poisons, so heavy metals, pesticides, chemicals. And I'm on the board of the environmental working group or ewg.org, and they have great guides on how to reduce your exposure in food and household cleaning products, skincare products. And it's really a great comprehensive approach to looking how to minimize your exposure to environmental toxins, which I would encourage you to do because we're all kind of inundated. The third thing is, you know, you can have thyroid problems, which is about one in five women and one in 10 men. That's a lot of people. That's 20% of women and 10% of men have some type of low thyroid function. And about 90% of those are inadequately treated. They often be given maybe a little bit of Synthroid or T4, but doesn't actually address the entire need of the thyroid to function properly because T3 is the active hormone. And when that's low, then your thyroid doesn't work. And thyroid is necessary for your mitochondria to function properly, for your energy to be burned and so many other very important functions. So that's another factor. So insulin resistance, toxins, and obviously, obviously thyroid. So those are three big ones. There are many more, but those are the three big ones. So then what do you do to actually increase your metabolism? Obviously, you have toxins, you gotta get rid of them. If you're thyroid, you gotta fix it. If you're insulin resistance, you have to really cut the sugar and starch. But in terms of increasing your metabolism, the best way to do it, there's couple of key ways to do it. One is through what you eat, right? So certain things burn better than others. For example, fats burn much cleaner than starch and sugars. Protein also helps to improve your muscle function and muscle mass and metabolic function. So it's really important to get the right quality protein, the good fats and the cut down on the starch and sugar. Essentially what I call the Pegan diet. And there's more kind of aggressive versions called a 10-day detox or 10-day reset, which essentially about getting your body kind of rebooted and your metabolism rebooted. The other thing is exercise because we often don't know how to exercise or exercise the right way. There are two key ways to increase your mitochondrial function and number, make them faster and better and smarter, and also to actually increase the amount of mitochondria you have. To increase the amount of mitochondria is basically through strength training. It can be body weight, it can be bands, it can be but, you know, weights, whatever, whatever works for you. There's a lot of approaches out there to increasing muscle, but you have to build muscle. No question about it. If you want to be healthy, muscle is health. And if you age, your metabolism slows. You might, for example, see someone who's very overweight and say, God, they're not eating that much. How come they're so fat? Well, it's because their metabolism is slow, slow because they've lost so much muscle and they've been replaced with fat. Or people who are older, they can have an appearance of looking thin, but they're actually fat on the inside and they're far slower in their metabolism and end up in trouble. The other key thing is something called VO2 max. VO2 max is essentially the amount of oxygen you can burn per minute in your mitochondria, which is also limiting the amount of calories you can burn and how much energy you can produce. So elite athletes like Lance Armstrong, one of the Tour de France, his VO2 max was like 90 something. So he could just climb up those mountains to France with no problem because he could just continually burn energy and run his. It was like a Ferrari, right? Otherwise, you know, many are like a tractor, can't go more than 30 miles an hour because they basically screwed up their metabolism with their diet and lack of exercise. So VO2 max is in diabetics, for example, might be 15. If you're a relatively healthy, you know, 40 50 year old, it could be in the 40s, 50s or more, depending on if you're an athlete. So you want to increase your VO2 max. And the best way to do that is to actually do what we call interval training or high intensity interval training. Essentially, it's where you're doing sprints, so slow, fast, slow, fast. You might have to exercise long, but you exercise smarter. So you could go for a one hour slow run, or you can do a half an hour of interval training and get much more benefit by exercising far less time in terms of your energy efficiency, your metabolic rate, and your continual metabolic rate after even you're not exercising. So it's not what happens while you're exercising, It happens not how many calories you burn while you're exercising is how your mitochondria are after you exercise. Are they burning a lot of calories? The best way to do that is to do this high intensity interval training. There's a lot of techniques for doing that, but essentially it's just simple as, you know, sprinting for 30 to 45 to 60 seconds as fast as you can, like you're riding with a tiger and then slow walk or slight jog for, you know, three minutes. So it's 30 to 60 seconds fast can three minutes. It's kind of chill. That's just one technique, but there are many and I think it's really important. to understand at any age, you can increase your mitochondrial function, you can increase the mitochondrial number, you can increase your metabolism and actually lose weight. So I love to eat a lot with my thing. So I actually make sure I have a high metabolic rate by making sure I do all those things in terms of the quality of food that I'm eating and also the type of exercise I'm doing.

No, that's really great information. I think that it also goes to, you know, a lot of people think that, well, I'll just eat less, you know, and it's really important to consider other factors.

No, well, no, because our calories are direct to starvation. So we start to, over time, eat less. So those are metabolic rate. Yeah. You'll see this a lot. People will lose weight initially with calorie restriction, and then they'll just plateau. They'll just hit a, they'll just hit a floor, and they can't lose any more weight. And I think that's just because the metabolic rate slows down. If you lose losing weight, you have to do strength training because you will lose muscle and fat. And often when we gain back the weight, we gain back only fat. And so we end up, if we yo-yo a little bit, we end up in a much worse metabolic States. You end up having to eat less calories. then you did it the same weight before you did the weight loss. Because if you yo-yo up and down, you're going to just keep replacing muscle with fat, and that's going to just screw up your metabolic rate because muscle burns seven times as many calories as fat.

Wow.

Okay, good information. Darcy, we'll go over to you for the next question.

Yeah.

Before we jump into the next question, I have one follow-up for the one that you just said, Dr. Hyman. And that's, is there a way to test how many mitochondria you have? to know, oh, I'm actually increasing them or not?

Well, you can look at the mirror and your muscles, that'll tell you. In terms of function of mitochondria, there is a test, it's called VO2 max. And essentially, it's the liters of oxygen you can burn per minute. V is volume, O2 is O2, and max is maximum, right? How much volume of oxygen can you burn per minute? The way to do that is a bit complicated. There are kind of cool metabolic rate tests like Lumen is a cool little device that actually track it at home using your breath. It's probably not as accurate as, for example, we'll call it a cardiometabolic stress test, where you go to treadmill, your face is hooked up to this mask, which measures the amount of oxygen you're breathing and how much carbon dioxide you're actually producing. And through that, through mathematical equations, you can figure out based on how much oxygen you're taking in and carbon dioxide you're breathing out, what your metabolic rate is and what your VO2 max is.

And what's fascinating is your VO2 max.

Is correlated in a linear way with longevity.

So the higher your VO2 max, Longer you're gonna live. Heck, yeah. Okay. I like that.

So after this, I'm gonna go do some sprints. Right?

Yeah, me too. Geez, okay. All right. So switching gears, I kind of want to bring up a topic that's been really, really common and it's being talked about more and more as we're bringing light to mental health, and which is an amazing conversation. I'm so glad that people are really opening up about that. But I also think that there's definitely a role for functional medicine when it comes to mental health and really supporting the best possible mental health that we can when possible. And so I just kind of want to bring up the topic of anxiety. Is there a cause and is there a way to approach treating anxiety using functional medicine, whether it's in conjunction with prescription medication or what have you. I know that there's just so many facets that play into it, but if you could just kind of, if we could just pick your brain about anxiety a little bit.

For sure. Well, it's a pretty rampant phenomenon in society and from mild anxiety to just severe crippling anxiety. And we spend tons of money and people use medications, use narcotics, use, you know, street drugs, everything to kind of manage their anxiety. And the way I like to think about anxiety is really twofold. One is what's causing it from the outside or what could be causing it from the inside. And what I mean by the inside is what are the biological reasons that have nothing to do with your life circumstances or your thoughts, but have to do with biology. And then one of the things that are really from life stresses and circumstances that overwhelm us and make us having have trouble kind of managing. I'll just start with the things that come from inside. You know, most people don't realize this, but if you eat sugar or starch, and I'm talking about this, but it's just so fascinating. We look at the data. If you, if you give kids oatmeal for breakfast, literally just oatmeal, which you think, oh, that's a healthy breakfast. And we're not even talking about Fruit Loops or Captain Crunch or Cocoa Puffs, right? Which is basically the American breakfast or muffins or bagels or whatever, but, like, Oatmeal. If you give them oatmeal, and by the way, it's gonna be much worse for those other things, then it releases adrenaline and cortisol into the blood. So when you're anxious, you release adrenaline. It's anxiety. You get pumped up with adrenaline. And so you feel jittery anxious, your body like feels like that and you get mentally anxious. That could just be coming from what you're eating. Okay? It literally can come from eating sugar and starch. And of course we see this. We see, you know, kids who sugar binge and are bouncing off the walls at a party like you don't have to be a PhD scientist in sugar to figure that out. And the other thing that can cause it is your microbiome. So anything that causes inflammation can cause anxiety. And one of the biggest drivers of inflammation is the microbiome, the imbalances in the bacteria in our gut. We have three pounds of bacteria in there. They're all doing important jobs and there's more neurotransmitters in your gut than your brain. There's so many nerve endings, almost as much as your brain. And there's a constant bidirectional communication between your brain and your gut. And we know people have quote, irritable bowel syndrome. and we tend to label them. This is what we've done when I was in medical school as sort of neurotic, anxious people. And we had a really pejorative joke that we used to say, which is, it's always super tentorial. It's this fancy way in medical terms to say it's in your head. You know, your tentorium is like the part of your brain, which is like above a certain area. So that's always a super tentorial phenomenon, whatever it means. You're just, it's in your head. And. what we're learning is the opposite is true. Actually, the irritable bowel can cause an irritable brain and that can lead to anxiety and behavioral issues and all sorts of things. The other major reason is hormones and fluctuations in hormones that can drive anxiety, whether it's PMS and hypothalamic symptoms. And there's a lot of reasons for hormonal disruption. That's a whole another rabbit hole I could spend an hour on. But essentially, what are the causes of hormonal disruption? And it's the usual stuff, right? It's our processed American diet. It's high sugar and starch. of good fats, it's lack of enough fiber. It's all the inflammatory foods we eat. It's all the estrogenic foods we eat. It's the dairy and the hormonally active foods we eat. It's lack of exercise, it's stress, it's caffeine, it's alcohol, lack of sleep, even changes in our microbiome. All these things can affect hormonal balance and lead to anxiety for women. And that can be particularly important around the cycles and PMS. So those are really important to think about. So you've got some big internal reasons and then we've got nutritional deficiencies that can cause anxiety. If you have low magnesium, if you have low omega-3 of fats, if you have low vitamin D, those are all really important things to think about. So there's a lot of sort of medical reasons. And I remember there's one guy, he was like, it's kind of very overweight guy, and he's like, Dr. Hyman, I am just struggling so much with panic attacks. Every afternoon, I get terrible panic attacks. My heart races, I have palpitations, I can't breathe. I feel like I'm going to die. I start sweating. I'm like, oh, really? Okay, tell me about what you're doing around that. He says, well, you know, I really don't eat much, but I drink Coca-Cola all day. And then I get, and then I get this in the afternoon. I'm like, oh, well, you're probably having huge sugar swings and you're hypoglycemic. And when your blood sugar drops too fast, it's a life-threatening emergency. So what happens? Cortisol, which raises your blood sugar or adrenaline kick in, you gotta go find some food. So it's like, you know, even low blood sugar and swings can low blood sugar can drive anxiety. So there are a lot of biological reasons for anxiety. and then, and then of course there's the, and so in other words, in how to treat anxiety, I always think of that and like, I'm not going to assume this person's neurotic or crazy or some other problem. I'm gonna, I'm gonna dig in and figure out are there reasons? Because the body affects the brain. Sort of what I wrote about in the mind body, starting the alter mind solution, which essentially I wrote a book, I wrote about more than 12, 13 years ago. And it, it was really the first time I think people had really started to think about how do we not just treat the mind body? affect, right? Our thoughts affect our biology, but how does our biology affect our thoughts? How does our body affect our mind? And that's really an important discovery. So I wrote a whole book about it. It describes how to do this, but I think those are important. And then, of course, there's life stresses, you know, whether it's work or relationships or kids or family or climate change or the economy or covid, whatever is, you know, making us all a little nervous, right? And so your ability to handle anxiety also is depending on all those things being okay. So you want to be anxiety resilient, but then I think there's some really wonderful things to do to deal with our minds, because those are the things that generate a lot of anxiety. So before I get into the mind stuff, there's things people can do to just help really improve their overall level of the nervous system, to calm down the sympathetic nervous system, and to increase the function of the parasympathetic. That's the relaxation nervous system, sympathetic as the stress nervous system. sort of the fight or flight or freeze or, you know, feeding, reproduction, and sort of the key functions of this ancient part of our brain that keeps us from danger. So, we want to calm that down and we want to increase the parasympathetic system. And again, there are a thousand ways to do that from meditation to yoga to massage to hot and cold, like a sauna or a cold dip, cryo, there's all kinds of ways to access the nervous system to the skin, through breathing, through breath work, who guided imagery, through Reiki healing. There's a thousand ways to do it. Acupuncture, all of which will be helpful. And I encourage you to find the things that work for you. I know my go-to's are meditation, hot and cold therapies, breath work, massage. You know, I think you just have to find what works for you. But, you know, there is a deliberate and intentional strategy for helping manage that constant dynamic between, you know, fight or flight, you know, and parasympathetic nervous system, relaxation. Super important for people to figure out and hack for themselves. Because if you don't, life will just amp you up. It's just that we live in a weird world of technology and disparities and environmental stress and economic stress. And it's just like, it's a lot for people, just, just daily life. So I think, I think learning these techniques can be super, super helpful. So those are a huge take home, and then there's there's other things you can do. For example, herbal therapies can be great. And there's great things like theanine, GABA. These are natural amino acids and compounds, for example, green tea you can take. There's certain herbs that are great, like valerian, kava, passionflower. And there's many, many calming herbs that people can use to help chamomile. And so you start to begin to maybe incorporate some of these into your life. So I encourage people to do that. My favorite is a hot Epsom salt bath. I call it the ultra bath. It's basically a lavender drops, which lowers cortisol. Lavender drops is you can get essential oils, two cups of baking, a cup of baking soda, two cups of Deft and salt, hot, hot, hot water as hot as you can stand it and stick soak in there for 15, 20 minutes. And I promise you, when you come.

Out, you're gonna be so relaxed. So that's a good way to handle anxiety. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman. Plus, if you want to listen to the full episode and get access to ad-free podcast episodes, plus Ask Mark Anything episodes, plus monthly functional deep dive episodes, I guess that's why we call it Dr. Hyman Plus, then head on over to the Doctor's Pharmacy on Apple Podcast and sign up for your seven day free trial.

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