Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Insulin Resistance

Hey everyone, it's Dr. Mark Hyman here. Now 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, you, 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. Now 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 featuring our very own Dr. Elizabeth Boham 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.

Welcome everyone. My name is Dr. Elizabeth Boham and I'm a functional medicine practitioner. and a physician and medical director at the Ultra Wellness Center in Lenox, Massachusetts. Welcome to Dr. Hyman Plus. We are so excited to share this with you. This is really the functional medicine deep dive. We wanted to put together these lectures so that you could really take a specific topic and dive in deeper, figure out more about the topic you want to learn about. How do we look at it as functional medicine practitioners? what kind of tests you can ask your doctor to do? What can you do in terms of your lifestyle and day-to-day living that can help improve a situation if you're dealing with it? How do you understand how all the different systems in the body are working together? And what can you do to rebalance your body so that it's functioning at its optimum? So, you know, today we're going to talk about insulin resistance. And we really wanted to talk about this because it's so common and we see it all the time and it's so important in terms of your risk for disease and just not feeling your best. So we're going to delve into that today. So as I said, my name is Elizabeth Boham. My undergraduate and graduate degree was in the field of nutrition and exercise physiology. I was blessed to meet Mark Hyman at Canyon Ranch in 2004. That's when I started learning about functional medicine. I joined the Ultra Wellness Center in 2007. I am a board certified in family medicine and I'm an IFM certified practitioner. I'm the medical director at the Ultra Wellness Center in Lenox, Massachusetts. If you want to learn more about our practice, about myself, what other things I have going on, please feel to feel free to follow me or check out these websites here. Okay, so we're gonna really delve in, as I said, to insulin resistance today. And the reason we wanted to talk about insulin resistance is because it's unfortunately so common and we know insulin resistance is a driver for so many different diseases. But we've got an epidemic going on. You know, these numbers here really don't even appreciate the full issue of the problem. You know, this is really the, you know, we're dealing with much more a higher percentage than we see here, but at least 5% of our children and at least 50% of us over the age of 60, you know, as, you know, we see lots and lots of, you know, up to 80% of people who are not metabolically healthy. And we're going to talk about how do you know if you have insulin resistance, how can you figure it out, recognizing that it's a continuum. It's not like you either have it or you don't. a continuum involved. And that's why, you know, we realize that there's probably a lot more people than what we see here in terms of this five to 50% in this data from N Haynes. Okay, so potential consequences of insulin resistance. I didn't realize I didn't have this animation involved, but it's kind of a good place to start, isn't it? Because I just added this to this slide because we know and we're appreciating how insulin resistance and high levels of blood sugar increase our risk of infections and not doing well when we get an infection. In fact, unfortunately, with COVID-19, we're seeing a predominance of when people aren't doing well when they get COVID-19, they have the metabolic syndrome, insulin resistance, obesity, hypertension, as issues going on with them, and those people are not doing as well. It's just another reason that we want to figure out who has insulin resistance and figure out how we can reverse this. because it's going to make a huge difference. And what's important to recognize is that the small steps you make every day will start to reverse this process in your body. And when you work to lower insulin, and I'm going to explain to you what that means and how do you know if you're lowering it and everything, but when you start to lower it right away, you're going to have improvements in the functioning of your immune system. So right away, when our insulin levels are in better control, when our blood sugar is better control, our immune system is in better control. We fight off infections better, we fight off the flu better, we fight off COVID-19 better. And that's been really interesting to see with the data coming out recently. But there's a lot of other things going on that insulin resistance causes. It's a major cause of cardiovascular disease. It's probably the number one or will be the number one cause of cardiovascular disease. It changes your lipid panel. So that dyslipidemia there, it changes your cholesterol in a really unhealthy way. and we're gonna talk to you about what that is. It causes an increase in blood pressure. It causes erectile dysfunction in men. It's involved and associated with infertility and polycystic ovarian syndrome. That PCOS is a syndrome where women can have multiple cysts on their ovaries, but also are struggling with infertility. And that's directly tied in with insulin resistance. Insulin resistance is associated with increased cognitive decline and it's definitely associated with an increased risk of Alzheimer's disease. It's associated with osteoporosis because it's associated with inflammation in the body. NASH is non-alcoholic steatohepatitis or fatty liver. So it's associated with fatty liver disease and young people needing liver transplants because of fatty liver disease and their liver not working optimally. So that detox organ gets replaced by fat, and as a result, the liver gets damaged. It, of course, is associated with weight gain and obesity. Unfortunately, when people have insulin resistance, they really struggle with maintaining a healthy weight. And in fact, one of the main reasons people come in to see me is because they're frustrated that they cannot maintain healthy weight and they can't lose weight and they just keep gaining weight, especially around the midsection. So that high level of insulin, we're gonna, I'm gonna explain that all to you, really causes us to deposit weight around the belly and causes insulin insulin resistance. And insulin resistance causes us to gain more weight around the belly. It is this vicious cycle. Sleep apnea is definitely associated with insulin resistance. Again, another vicious cycle. We see that sleep apnea causes insulin resistance and insulin resistance causes sleep apnea. So definite vicious cycle there. When you're not getting adequate sleep, when you're not getting enough hours of sleep, When your sleep is interrupted with these apnic episodes where the body's not getting oxygen, then what happens is levels of insulin go up as markers of inflammation and that causes people to gain weight for their blood pressure to go up and increases their risk of sudden death. It's very important to make sure or screen for sleep apnea. Cancer, unfortunately, insulin resistance is associated with many, many cancers, including breast, uterine, colon, lung, definitely something we need to be paying attention to. And when we're working with somebody to decrease the risk of getting cancer for the first time or treating their cancer and working to reduce the risk of getting a reoccurrence, we are working to improve insulin sensitivity all the time. Cancer loves to grow. It loves to grow when there's inflammation around. It also likes to grow when there's insulin around. Think of insulin as like a growth hormone. It causes things to grow. It causes our belly to grow. It also causes cancer to grow, unfortunately. And of course, insulin resistance is associated with type 2 diabetes. And for, you know, for different people, the time it goes from developing insulin resistance to developing type 2 diabetes is very different. That depends on your genetics and so many other things going on in your body. It may be five years, it may be 50 years, but there's a Continuum of insulin resistance. And over time, when the insulin doesn't work very well, then over the blood sugar starts to go up and then you can get the diagnosis of type 2 diabetes. So definitely insulin resistance is associated with type 2 diabetes. When somebody has type 2 diabetes, they have insulin resistance and they may have had insulin resistance for 10, 15, 20 plus years prior to getting the diagnosis of diabetes. And what we realize, what we realize is that even before somebody gets the diagnosis of diabetes, having insulin resistance, high levels of insulin floating around, increases your.

Risk.

Of heart disease, of Alzheimer's disease, of stroke, of cancer. So you don't have to wait till somebody gets diabetes before you intervene. Really important. And what we are trying to teach practitioners worldwide to really try to find insulin resistance early so they can reverse it early and so many of these sequela that can occur because of insulin resistance. It's also really important to recognize that this is very, very reversible. You know, everybody based on our genetics, what else we have going on, you know, it varies in terms of how easy it is to reverse and what they need to do to reverse this process. But it is very reversible. We see it every single day. It's something that I love to do in my practice is watch the insulin level improve, watch all of these issues that somebody's dealing with improve because we're getting their insulin lower. And that's what we're gonna really talk about over the next hours. We're gonna teach you how to do that. So, you know, this here under my picture here says organ. So adipose tissue is a very active endocrine organ. What that means is that our body fat, it's not just sitting there. We think, oh, you've got this extra body fat, it's just hanging out. And if I could just liposuction it away, everything would be okay. But unfortunately, that body fat is very metabolically active. It's doing a lot of things. It's not just hanging out. So it's producing here, this study from many, many years ago showed how it's producing a lot of inflammatory markers, right? So it's producing things like interleukin six over here and tumor necrosis factor and all these other interleukins and these things go on to increase inflammation in the body. So it's not just hanging out, and they've actually done studies on liposuction, right? If we could just liposuction some of that fat away, what happens? Well, unfortunately, for your blood work, not much happens. So people don't become metabolically more healthy, they do not become metabolically more healthy, When you liposuction that fat away. So that's really important to recognize. In addition, the concerning fat, the much more concerning fat is the deep adipose tissue. So the tissue that's in the viscera, that's deep in the belly, not just like, can you pinch an inch fat? That is, you know, you might not want to have it, but the more concerning fat is the one deep within the body. okay? I'm going to show you some pictures of that. So here, this, this, these, and there's a couple slides in here that the International Chair on Cardiometabolic Risk, their website is down here that they have available on the website that I thought was really, they were just well done and I wanted to kind of include them just because I think they really tell the story very well. So what they're showing here is that deep belly fat, that visceral adiposity on this gentleman here, this adipose tissue, is producing these inflammatory markers, interleukin-6, tumor necrosis factor, that goes on to increase C-reactive protein, which is a biomarker of inflammation in the body. So C-reactive protein is a blood test you can have your physician do that will measure how much inflammation you have going on in your body. So this is just one of them, but it goes up for many people. And that C-reactive protein is a major risk. That inflammatory, those inflammatory biomarkers cause plaque buildup in the arteries in the body. So here, this is a cross section of an artery. And when there's inflammation going on in the artery, plaque is more likely to build up in there. And then that can cause an acute heart attack in somebody. There's many other things that can cause a stroke, it can cause just build up of decreased elasticity of the endothelium and the blood vessel and increased hypertension. But this is just showing that that belly fat is involved with increased inflammation and all those diseases we've been talking about. Again, I love this slide because it shows you when you're talking about visceral adiposity, that that belly fat around the organs here shown in white, all that belly fat around the organs is the fat that we're really concerned about. This fat on the outside, so this is a cross-section of somebody's abdomen if it's hard to understand, and this is a CT scan, so that the belly fat here is shown in white around the organs. And this is very concerning because it's It's highly inflammatory fat. This fat out here that you could pinch, you know, when you pinch an inch, isn't as concerning in terms of risk of heart disease, inflammation, and disease in general. And as we talked about earlier, this belly fat is associated with the wrong type of cholesterol pattern, insulin resistance, elevations in blood pressure, a pro-thrombotic state, which just means you're more likely to develop blood clots, and more inflammation. And we know that inflammation can result in weight gain, can result in cancer, can result in so many processes in the body that we're really concerned about, like disease. Here showing that even if weight is the same, even if weight is the same, the more red they did the intra-abdominal fat in red here, the more red, the more belly fat somebody has, the increased risk, the increased predictor of mortality is seen. The risk of disease goes up. So, you know, if you're wondering, what can I do to stay healthy? What can I do to live a long, healthy life? What can I do to prevent disease? What can I do to reverse disease that I may already have? One of the things that we work on with almost all of our patients is improving their insulin sensitivity. because it has such a huge impact on all the diseases in the body.

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 so we call it Plus, right? 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 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.

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