Exclusive Dr. Hyman+ Ask Mark Anything: Fish Oil Supplements, Leaky Gut, And More

Hey everyone, it's Dr. Mark Hyman here. My team and I have been working hard on something that I'm so excited to share a little bit about today. It's a revolutionary new platform called Dr. Hyman Plus, which is a premium membership exclusive for my community. With Dr. Hyman Plus, you get a ton of private content and special access that no one else gets. This yearly membership gives you exclusive access to ad-free Doctors Pharmacy podcast episodes, access to all of my docu-series including the Longevity Roadmap and Broken Brain 1 and 2, plus all the bonus content. You get monthly Functional Medicine Deep Dives where one of our doctors goes deep into a health topic to tell you everything you need to know to heal. You'll also get access to a monthly Ask Mark Anything Q&A where I answer the Dr. Hyman Plus Community's biggest health and wellness questions. This Q&A is only accessible with a membership. Because I'm so excited to share this premium membership content with you, I'm releasing a teaser of the brand new Functional Medicine Deep Dive episode diving into one of the most important topics in health. I hope you enjoy it and head over to drhyman.com/plush that's drhyman.com/plus for more information. Okay, here we go.

Hi everyone. Thanks so much for tuning in to the newest episode of Ask Mark Anything. My name is Harshil Parikh and I am the Community Manager for Dr. Hyman Plus. We've collected some of your top questions for Dr. Hyman this month and we're going to ask Mark anything. So we're excited to hear what he has to say about your top questions. Let's go to the expert himself. Hello, Dr. Mark Hyman.

Hi, how's it going everybody?

We're so glad that you're here and we're so glad to be able to ask you these questions. So let's get started. The first question that we have is from a community member who wants to know about omega-3 supplementation. And the question that they have is that there are so many articles that have conflicting information on whether or not omega-3 supplementation is helpful or is it necessary. How do we sort through all the articles and studies to find out what's important? And what are your opinions on it?

Thanks, well, the truth is that nutrition science is very confusing, it's very complicated, and it's hard to parse out specifics. And it's also very reductionist, right? So the current study that was published, which is called the Strength Trial, which is a randomized clinical trial done through the Cleveland Clinic, by Steve Nissen, who's a friend of mine and top NOST researcher, randomized groups of people to either taking four grams of fish oil or a corn oil alternative. And they really found no difference in the outcomes. And they picked patients who were at high risk for heart disease. But if you look at the sub-characteristics of the patients, these were people who were all pretty sick already. And so the question is, if you were to take a group of people who are generally healthy and not high risk and you follow them over many decades who had adequate levels of omega-3s, what would be their outcome? We just don't know. And again, it was relatively short-term study, but there was really no difference in the outcomes. The challenge is also what are the characteristics of the patients? Are they smokers? How's their diet? How do they differ? We don't really know. What's the overall context? And the thing is, if you're using a natural substance like fish oil, it's different than using a drug. They work in different ways in concert with the body, not like a drug in a reductionist way. They may have more subtle effects and they may have obviously we call pleomorphic effects. In other words, there's many, many different effects from a substance. When you take a drug like a statin, it has extra effects, but it primarily lowers LDL and it reduces inflammation. It hits a specific enzyme, a specific pathway. With fish oil, for example, it works on hundreds of different sites in the body and it's essential for our health. You cannot survive long term without omega-3 fatty acids. That's why they call them essential fatty acids. They are essential for life and you cannot get them other than from your diet and primarily from wild fish or wild plants. Although you can get obviously from fish oil supplements. Now, not all fish oil is the same. what kind of fish oil were they using? Was it contaminated with toxins? Was it oxidized? And so forth. What were the underlying health of the patient? It's challenging to look at these studies and draw the conclusion and say this is definitively shows that fish oil is useless. Forget about heart disease. When you're looking at one disease, one condition, one substance, It's not how these natural substances work. For example, magnesium works on 300 different enzymes. Omega-3 fats are involved in the formation of your cell membranes, are critical for cell communication, regulate inflammation, are critical for your hair, your skin, your nails. They're critical for mood, for cognitive function. So they have so many other benefits in the body. And even if maybe they're not hugely effective for someone who's had a heart attack or about to have a heart attack, to prevent a second one or one that they're about to get, it doesn't mean that they're not useful as part of your overall health regimen. Clearly they're not dangerous, although there was some evidence that there may be some increased risk of arrhythmias, although it doesn't quite make sense because other studies have shown like the trials in Italy where they actually intervene with fish oil, they found dramatically lower levels of arrhythmias or irregular heartbeats and death after getting fish oil. So I wish nutritional research was simple and straightforward. It just isn't. And you have to look at the overall context of all the research. What are the biological mechanisms? How does it work in your body? What other functions does it have in your body besides, for example, just your cardiovascular health? So it's important to sort of be more critical and more thinking about it, not just say, oh, I'm not taking fish oil anymore because this one study showed it doesn't work for this particular condition in this population, which may not be generalizable to you. I can tell you clinically from seeing thousands of patients, that many, many, many Americans are very deficient Omega-3 fats. And it's so critical for brain development. I mean, if you're giving a baby formula, their IQ point is our average seven points lower because there's no Omega-3 fats, although now they realize this and they're putting Omega-3 DHA into the, you know, in, in, they're putting it into the formula. In fact, in this study, if I'm not wrong, I'm going to double check, but I think what they did was they gave them EPA, which is just one component of Omega. Oh, no, they gave both EPA and DHA. So they did both, and they were basically given four grams. So I think that, you know, again, I wouldn't dismiss it. I think, do I take it? Absolutely. Do I think that it's necessary for it? or health and mortality, absolutely. I think it's important which one you get. So they're not all the same. You can get fish oil from companies that don't necessarily test for purity, for potency, they may have contaminants, they can have a lot of petrochemicals in them, heavy metals, because the fish themselves are contaminated. So it's important to get the right fish and the right process for extracting the oil. For example, Dutch Harbor Omegas is a fish oil from cod liver oil that comes from Alaska developed by my friend and colleague and mentor Jeffrey Bland, which is for sale at Big Bold Health. And it's processed in a very different way. And what it does, aside from taking out all the toxins, it's at very low temperature and pressure. So preserve within that fish oil. This may, for example, not have been in other fish oil. are these things called pro-resolving mediators. So we know people, for example, who eat fish have less heart attacks, right? And longer life. But they're getting the whole fish oil without any of these sort of weird extraction methods. It may alter the characteristics of the fish oil. For example, it might cause it to oxidize, but maybe it heats it up in a way that it destroys these compounds called pro-resolvins or pro-resolving mediators or serums are selective pro-resolving mediators. And these are the effective anti-inflammatory compounds in fish oil. They're like the brake on your immune system. So they're designed to resolve inflammation, that's what I call pro-resolvins, but they're very diminished in most fish oil. So maybe the fish oil they were giving the study didn't have any of these pro-resolving mediators. You need the right fish oil. So you might have been given the wrong drug, and of course, they're not going to see an outcome because the benefits come from these pro-resolvins in fish oil. that you get from eating fish naturally, but you wouldn't necessarily get if you have the average fish oil. So it's important to be more discerning and discriminating about where you're getting your fish oil, what the company's process is for manufacturing and harvesting it. So I, I, I think my favorite new fish oil is the Dutch Harbor Omega from Cod liver oil, which also contains vitamin A and vitamin D. And it doesn't have a bad smell, doesn't have that taste. You get the liquid, you can get the you can get the capsules. And the funny thing is that, you know, that when you have a fish oil that's properly extracted, it doesn't smell. It doesn't smell that. If you get the ones that are smelling and bad, you know, you may not be getting the right one. So again, these are just some of the nuances and thinking behind why you didn't just go, oh, this one study showed this. That's it. It means the fish oil doesn't work. Well, what fish oil? In what patient? Under what circumstance? Like, this is more detail. So I hope that answers your question. I know it's A lot, there's no easy answer, but bottom line is yes, I still use fish oil. Yes, I recommend fish oil. Yes, it's good for many, many other functions of the body besides the heart, even if that didn't work. So, like your brain and your skin.

Your hair and your nails, and regulating inflammation. So, I think it's really important to use. No, that's definitely very helpful. And obviously what we're hearing is that quality matters. So, you had mentioned just one fish oil that you like, and of course we'll put the link to that in the notes so that anyone who's interested will be able to get that. and find that product. So thank you so much for that. The next question is about alkaline and acidic foods. What's your theory about, you know, foods having acidity or alkalinity? And, you know, does that impact bone health or overall health in general?

Yeah. So I think, I think there's a lot of confusion about acid-based balance in the body. And, and there's, there's whole approaches of eating an alkaline diet and so forth. and I just sort of like to sort of break that down a little for people because it can get kind of complicated. Your body has got a tightly controlled pH, which is the acid based balance, right? Acid alkaline. And if you eat a highly processed industrial diet, you'll be eating a very acidic diet, sugar, starch, you know, processed foods, refined oils. These are industrial animal products, which are highly acidic. and they will slightly change your pH toward an acid state. The key is that every chemical reaction in your body requires a certain pH in order to function and to optimize their metabolic processes. So if your pH is off even a little bit, it does have a negative impact on your health. So we all want to be more a little out. Our human pH is 7.4, 7 is 0.0 is the middle point between acid and base, right? So 7.4 is a little more towards the alkaline side. So how do you achieve that? Well, not that hard. You eat a whole foods plant rich diet and get rid of junk and processed food and you'll be eating an alkaline diet. I mean, if you want a lot of alkaline foods, just make a big pot of root vegetables and greens and boil them down and drink the broth. Super alkaline. that's sort of an easy tip. People who drink alkaline water, I think it's really important. Now, in terms of acid-based balance and bone health, for sure, for sure that if you are on the acidic side, it does increase bone turnover and bone loss. So it's important to make sure that your diet is overall balanced, that you're eating a more of a whole foods plant-rich diet. The Pegan diet is sort of common sense, and obviously if you eat a bunch of crap, It's not going to be good for you and it's not good for your bones. Certain things are particularly bad for your bones, caffeine, alcohol, sugar, stress, phosphoric acid, which is in all the colas, processed ingredients, excess amounts of animal protein may be a problem for some people. So it really depends on your overall health. But I think people should focus on eating a alkaline diet but not go crazy with a lot of the rigidity around it, I think, and it's just achieved by eating a whole foods unprocessed, a plant-rich diet.

Okay, that's great. That's good information. So something that we're gonna talk about next is a question that we often get, and that question is, what is leaky gut? We hear a lot about that from different people. Obviously we've heard it from you, but some of our community members are like, what exactly is leaky gut? How do you deal with it? How do you know that you even have it? What to do with it?

Yeah, this could take an entire hour.

Okay.

I'm gonna try to summarize it, but. Thank you. So basically, your intestine lining is a giant surface area. The small intestine and the large intestine is basically the size of a tennis court, maybe two tennis courts. It's kind of folding in on itself, and it's got all these villi with lots of surface area. And that is where you interact with the outside world. It's where you absorb nutrients. It's where you keep out bad stuff like bacteria and food allergens and toxins. And the barrier is very delicate. It's just one cell between you essentially and a sewer. From your mouth to your anus is a two It's essentially outside your body. It's external and it has to filter what you put in there, literally pounds of foreign stuff every day. And so when that barrier breaks down, you get sick. The breakdown of that barrier is what we call leaky gut. And essentially the cells are one cell, but they're stuck together like Legos like this. And those cells can come apart, but normally the food, it's supposed to go through the cell called trans cellular transmission that then goes into your bloodstream and gets absorbed and goes to the rest of your body to do what it's supposed to do. But, you know, you've got 60 of your immune system that's right underneath the lining of your gut. And so if foreign proteins from food or bacteria leak into between the cells, we call it intracellular. intercellular absorption, that actually drives exposure directly to your immune system and it leads to inflammation throughout the body. And so leaky gut as a phenomena has been linked to not just allergic or autoimmune diseases that are obviously inflammatory and asthma and allergies and so forth, but also to cardiovascular disease, to obesity, to Alzheimer's, to cancer, to diabetes, to autism, to ADHD. I mean, the list goes on and on and on. I mean, it is probably the single most important phenomenon driving so much of chronic disease today is damage to our microbiome because of poor diet, because of stress, because of environmental toxins, because of the overuse of antibiotics and acid-blocking drugs and anti-inflammatories and all the things we do to bust our gut. And so, the key to longevity and the key to optimal health is really fixing your gut. And we've been working on a project really about fixing the gut called Gut Food, which is coming out soon. And essentially it's a program and a number of ingredients that really helped to repair leaky gut. Polyphenols, prebiotics, probiotics, fibers, immunoglobulins, things that really help to restore the integrity of the gut lining. Because when that integrity is damaged, your script. And sometimes it's worse for some people than others. And there's ways to test for it. So from a functional medicine perspective, we talked about the 5R program to repair the gut. The first is to remove things that are abnormal. And we'll get into the 5R. I just want to give you the overview. It's removing things that are abnormal to replace what's missing. to reinoculate with healthy bacteria, to repair the gut lining, and to restore the body through managing the stress response.

Well, I hope you enjoy 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 all the content from my docu-series, and of course any future ones we're going to release, plus monthly Ask Mark Anything episodes, plus monthly Functional Medicine deep dive episodes, I guess, right? That's why we call it Dr. Hyman Plus. Head over to drhyman.com/plus. That's drhyman.com/plus to learn more. I'll see you there.

Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.