How To Get To The Root Cause Of All Chronic Disease

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

88% of Americans, almost nine out of 10 Americans, are metabolically unhealthy. And what is metabolically unhealthy mean? It means they have high blood sugar, high blood pressure, or abnormal cholesterol. Hey, everyone.

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Episode of the Doctor's Pharmacy. Hi, this is Lauren Fein, one of the producers of the Doctor's Pharmacy podcast. Functional medicine is lifestyle medicine and a potent healer, as it provides a roadmap for healing from any condition. With the understanding that fundamentals like diet, sleep, movement, and more can create health or disease in the body, we can take action to create a plan for healing and longevity. In this compilation episode, Dr. Hyman talks with his business partner Drew Pruitt about using the principles of functional medicine to create balance in the body by changing our diets, reducing inflammation, managing stress, improving.

Sleep, and so much more. Let's jump in. A study came out last year that just even shocked me, which was that 88% of Americans, almost nine out of 10 Americans, are metabolically unhealthy. And what is metabolically unhealthy mean? It means they have high blood sugar, high blood pressure, or abnormal cholesterol. All of those are caused by insulin resistance. So hacking insulin resistance and getting your blood sugar balanced and normal is so key. That's why these new technologies of continuous glucose monitors are so helpful. They really should be looking at insulin though, because way before your sugar gets abnormal and you've got a perfectly normal CGM monitoring, perfectly normal blood sugar, but your insulin could be going sky high and crashing and sky high. It just keeps your blood sugar even. If that insulin is going wacky like that and if it's high, it's driving all these diseases. And I once heard a professor from Harvard, who was a preventive cardiologist, Dr. Jorge Pleskow, say in a lecture, if you could take a group of 100-year-old people, who are very healthy and had no cardiovascular disease, they'd have one thing in common. I'm like, what's that? They would be insulin sensitive, meaning their bodies with very little insulin can keep their blood sugar normal as opposed to needing tons of insulin to keep your blood sugar normal. So we've got a society where almost nine out of 10 Americans are on this accelerated path to aging and chronic illness. So that would be number one. Number two, would be to understand the role of sarcopenia, which is something probably people have never heard of. You've heard of osteopenia and osteoporosis. SarcO is muscle. Pena means less than, so it means less muscle, loss of muscle. And it's inevitable if you don't do something to prevent that, namely exercise and diet, that you will lose muscle as you age. So even if you're the same weight that you were at 25, at 65, you could be twice as fat and your muscle will look like a rib eye instead of filet mignon. You know, marbled fat. You don't want that. You want solid muscle. And that muscle is where your metabolism is. That muscle is how you regulate blood sugar insulin. That muscle is where your mitochondria are, which are the most important factors in terms of aging. So insulin resistance will cause mitochondrial problems and loss of muscle. So you need to both improve the function and the number of your mitochondria by two strategies in terms of exercise. One is the increase in muscle mass through strength training, and the other is increase in mitochondrial efficiency through kind of exercise we call HIIT training or high intensity interval training. And that actually causes a stress to your mitochondria and makes them work more efficiently so you can actually burn more calories, you can be more efficient and create a healthier system. So getting your mitochondria straight is so, so key. Getting your muscle straight is so key and getting your blood sugar and insulin straight is so key. Those are among the top things. There's a lot more and we can go into those. But inflammation is another big factor that causes aging. We call it inflammaging because every process of aging that we see, whether it's Alzheimer's, depression, dementia, cancer, heart disease, diabetes, obesity. These are all inflammatory diseases. Even high blood pressure is an inflammatory disease. So it goes down the rabbit hole of how do we live an anti-inflammatory lifestyle? What are the things we can do in terms of diet, exercise, stress reduction, sleep, supplements, various phytochemicals, and all these things that we can do to help reduce inflammation. So I think about mitochondria, I think about inflammation, I think about insulin resistance, I think about muscle. And when you start to sort of start with those big categories, there's so much you can do. and then there's multiple layers down of really finding out what are individual stresses. So maybe people have latent infections or they have toxins or their microbiome is a mess or they have significant nutrient deficiencies. So we go down those pathways too, but the big ones are the four I mentioned.

Now, what's interesting about those four items that you mentioned is that those things, which seem very simple when they get out of control, We have a whole list of different names to describe different diseases that are tied to every one of those. We have autoimmune diseases, we have neurodegenerative diseases, we have heart disease, we have cancer, we have almost all chronic diseases ultimately come back to those four in some context.

Yeah, so essentially there are a few final common pathways for disease. And this is what functional medicine looks at is what are the root causes So instead of looking at the downstream effects, which is heart disease, autoimmune disease, cancer, Alzheimer's, diabetes, obesity, et cetera, what are the root causes of those problems? And there's this whole conversation in medicine about comorbidities, which drives me crazy because there is no such thing. What that means essentially is, oh, as someone who's got multiple disease, you've got heart disease, you've got high blood pressure, you've got diabetes, you've got reflux, you've got this, you've got that. and we go, oh, these diseases are something you all have at one time, but they're not related to each other. It's all one problem. And so if you go to the root, you find tremendous leverage to change people's biology for the better and reverse all these diseases by focusing on first principles. You know, what functional medicine essentially is, is a framework for understanding the natural laws of human biology, just as we can build bridges and send rocket ships to space and build buildings and do innumerable things by understanding physics, the simple few laws of physics that can produce an extraordinary number of phenomena. The same is true in human biology. We in medicine have grouped and categorized and lumped people into 155,000 different diseases. That's ridiculous. When you look at the fundamental way the body works, the natural laws of biology, there are a few natural laws. there are a few basic systems in the body, they're all a network. And if you work on that network, if you work on that system and create health, all those diseases go away as a side effect. And aging, I think as we see it today, is just a different name for disease. So there are people who can be old but not sick, and those are the people I'm really interested in. And how do we get to that? And how do we reverse the biological age?

Yeah, as you mentioned earlier, we used to have people in our families and a lot of people can think back and maybe it was their great-grandparent who died in their sleep. Now, we're lucky if people have anything remotely close to that when it's their time for passing. My wife's grandfather just passed away recently at the age of 96.

Wow.

And up until the last year was in mostly good health and then had a lot of muscle loss and fell, as a lot of people end up doing, and that left him bedridden. And then a decline started to happen from there. But most people cannot remember the last time that they heard of somebody die from old age, which was just dying in their sleep. We die from cancer, dementia, heart disease.

And a whole list of other components. See, my dream, Drew, is when I'm like maybe 120, I go up to a nice cabin on a lake with my partner. We have a beautiful meal, nice glass of wine, make love, take a swim.

In the pond, and I go to.

Sleep and don't wake up. That's how I wanna go out.

Well, I wish for you that dream, and I wish for everybody else listening to that dream as well. Now, going back to these root factors that are there, I wanna make sure we understand the way that the world has changed that has led to these unique circumstances. So on the topic of muscle loss, a lot of people look and say, well, we didn't have gyms back in the day. So what's going on with our lifestyles today that we actually need to exercise where previously we didn't really have gyms before.

Well, technology and cars. I mean, we've got all these, you know, time saving devices and labor saving devices and things that make us not move, right? Whether it's our cars, whether it's our laundry machines, whether it's how we heat our homes, you know, instead of having to chop wood. So when you look historically at how people lived, they were just very active as a normal part of their life. And it wasn't that they had to go to the gym, they just lived their life. And you go to these cultures where you see very, very old people still out in the fields, farming, digging, picking, squatting. I mean, 99-year-old people in a full squat, having their meal, totally flexible. I think there's no reason we can't maintain that. And I think we've just lost our natural environment that we grew up in, which evolved in, which was a very active environment. We'd have to walk. We'd have to walk. think about it. If you lived in another town, how would you get there? Horse or you'd have to walk, right? And now we have all these technologies, like even electric bikes they have now, which is kind of funny. So it's like we need less of.

That and more just natural movement as part of our life. Well, speaking about these cultures, you this summer actually went to one of these cultures.

I did.

And you took a trip to Italy.

Tell us a little about that and some of the families that you spent time with. Yes, I went to Sardinia, which is one of the blue zones, which is an area in the world that has long lived people. And Sardinia has the longest lived males in the world, 100 year old plus, and they have 20 times the rate of centenarians that we do in the US. The question is why? And when I went there, it was really immediately obvious because they were a landlocked people who lived up in deep mountainous regions that were inaccessible to conquerors and invaders. So they preserved their traditions for thousands of years. And they still live in the same way. They still do the same thing the same way. And first, they're shepherds. mostly, and they're goats and sheep primarily, and they have their own garden. So everybody has their own garden. Everybody has their sheep and their goats and the shepherds, you know, have to walk five miles, 10 miles a day, every day, and move their sheep around, goat herders, similar things. And so they're just naturally interesting. I met this, this Pietro who is 96 years old, super cool guy, straight as an arrow, you know, super fit. mentally super sharp, booming voice, vital and full of energy. And he literally just kind of stopped the five mile hiking shepherding like a year ago. He really was working until he was 95. Now he's, you know, still active and doing stuff, but just incredible. And the food they ate was, you know, we don't call it that, right? It was all organic, it was all regenerative, it was all local, it was all seasonal. It was all the things we aspire to that they just naturally had.

That's just the only way that they can exist and not a big box store down the street.

No, and they, and what was fascinating is they had these, these things that were so embedded in their culture that they didn't even realize what they were doing. For example, they understand that in order for their cheese and their milk to taste good, they got to go get the goats to eat and browse on certain plants, certain wild plants. So they have myrtle and all these wild plants. So these animals are eating all these incredible diversity of wild plants that have phytochemicals that are anti-inflammatory, antioxidant, detoxifying, anti-aging, mitochondrially boosting, and you can get them when you eat that cheese and milk from those goats and sheep. If you go to a kind of regular dairy and have the milk, it's got none of that in it because it depends on what the animal ate. And one of those guys, Al Linto, said, you know, we season our meat before we kill the animal. We flavor our meat before we kill the animal. Like, what do you mean? He says, well, we feed it acorns and carob and all these plants to make sure that it tastes good. And so what's fascinating is taste and flavor are connected to the phytochemical richness of the plant or the food. And by the way, animal foods that eat these plants have these phytochemicals. So your goat milk eating these plants has, for example, as much catechins as green tea, which we know is really good for you. So it, it, it, the taste and the flavor go with a phytochemical richness and the phytochemical richness is directly correlated to the medicine. in the food.

Now, what's interesting is that they don't know the science behind all this.

No, they are just- They taste better.

They're just following nature's instinct and one of nature's ways of communicating with us is that food is information. And that when it tastes better, it's not only better for us, but it tastes good and it's better for the animal too.

Yeah, exactly. And you know, Dan Barber created a company because he's a chef who's created a company called Row 7 Seeds. to re-hybridize plants to increase the flavor. Now, he's a chef, he cares about flavor. But because he's, oh, you know, we have these butter and squashes that just taste like water. They're designed to be big and starchy, or tomatoes and various foods that are just built for shipping in a box across country and not smushing. They're not bred for flavor, taste or phytochemical richness. So when he's breeding plants to create new types of seeds for flavor, the.

Side effect is that they are more.

Phytochemically rich and hence more medicinal.

So now the question becomes, how can we start living more like these Sardinians? How can we take after this gentleman? I forgot his name that you mentioned.

Pietro.

Pietro. How can we start doing that? Let's go through a few different categories and we'll talk about some of the things that we can do that are inspired by Pietro and other blue zones around the world, and then some of the other things that you've learned through your explorations in the world of functional medicine. So let's start first about We've talked a little bit about what they don't eat, but let's talk about that a little bit more in detail. And I think one of the ways to do that is that what were some examples of foods that we're making up specifically the Courrier diet in that before photo that we showed earlier? My diet. Yes, that before photo that we showed earlier, what were you eating on a day-to-day basis? You'd wake up, give us an example of breakfast, lunch and dinner, which you genuinely thought at that time was very healthy.

Yeah, you know, oatmeal for breakfast, you know, maybe some whole wheat bread and an egg. I might, for lunch, you know. Let's pause there for a second.

I'm gonna cut you off a little bit, 'cause I really wanna make sure we break this down. So a lot of people just heard oatmeal, they heard whole wheat bread, and they heard an egg. And they're thinking, wait, I thought we're talking about the foods that led to you being quote unquote skinny fat or not aging in the best way. So how are those things tied into.

The root factors that you talked about?

Earlier?

Well, not the egg, but the other stuff. Flour and starchy foods and grains, if you're super metabolically healthy and fit and exercising a ton, you can tolerate more of them because you'll burn them off. But for the average person, oatmeal for breakfast is a terrible idea. Cereal is even worse. I mean, cereal is 75% sugar. And we think of oatmeal, oh, it's got fiber and it lowers cholesterol and does all these great things. It's a big snow job. When you look at the data, and there's one profound study done by my friend David Ludwig at Harvard, where he took a group of overweight young guys, kids, teenagers, and he gave them three different breakfasts, exactly the same calories, oatmeal, steel cut oats, omelet. And then he locked them in a room, they measured their blood every hour, and they tracked everything, and they said, when you guys are hungry, push this button, we'll bring you more food. So they could eat whatever they wanted. The oatmeal group not only had higher levels of insulin, cortisol, adrenaline, which is the stress hormone, so eating oatmeal literally was like being chased by a tiger in your body. Your body didn't know the difference. It actually made these kids hungrier and they ate 81% more food than the omelet group. Remember, they ate the same calories of omelet, oatmeal or steel cut oats. The steel cut oats was better, but they still ate 50% more food than the omelet group. So when you have starch or sugar in the morning, whether it's a muffin, a bagel, oatmeal, French toast, pancakes, fruit smoothie, whatever people are eating, it's the worst thing you could do. You want to start your day with protein and fat. So I was starting my day with starch, which is the typical American breakfast.

And often people might have orange juice along with it.

Orange juice.

So it's fruit juice and that on top of the oat.

And sugar in the coffee or whatever.

Sugar in the coffee. So basically having, as you say, dessert for breakfast. The amount of sugar that they're having for breakfast is- It's dessert for breakfast, right?

And it'll throw you on a metabolic roller coaster for the rest of the day. Absolutely.

Okay, so that was you.

And that would be a lot more grains, a lot more beans, a lot more what I thought were healthy breads.

So just pausing again right there, a lot of people who, especially if they're familiar with the world of plant-based eating and maybe learning from some of the best practices from other cultures, they think that grains, beans, those things are the foundation and actually might be the key to Even reversing climate change, right? This is a lot of the topic that people hear. So help us break that down and talk a little bit about that because a lot of people do think that that's the healthy way to go. And it's not that it can't be healthy. Let's talk about how it maybe wasn't.

The healthiest the way you were doing it. Well, I think there's a couple of things to parse there. One is, if we're eating ancient grains and ancient beans and we're having them in the context of an overall low starch and sugar diet and we're very active, like we all historically were when we were eating those foods over the last 10,000 years, you know, we probably do better. But the modernization of our industrial agricultural system has produced starchy, really starchy versions of these grains, particularly like flour, whole wheat, right? Even whole wheat flour made from dwarf wheat is a sugar bomb, right? It raises your blood sugar more than table sugar. So when you don't understand that the food that we're eating is a driver of this insulin problem we talked about with aging. We're never going to get through this. And so I, I'm very careful. Do I eat grains? Sure. Will I eat them every day as a staple? No. Do I have quinoa? Will I have black rice sometimes? Will I have a little white rice sometimes? Sure. But it's not something I eat on a regular basis. It's not something that I, I think is, is dangerous if you're metabolically healthy. But for people who are metabolically unhealthy, It's bad and we're talking about 88% of Americans. My blood sugar, my insulin is less than two. So I'm okay, I can tolerate a little bit, but I also work out a lot and I exercise and I burn it off and I do a lot of other things to optimize my health. So in a perfect world, yes, you can tolerate more, but what I see often is very low levels of protein in vegans. I see this over and over and I wish it weren't true, but I have to believe what I'm seeing, which is people have low energy, they lose muscle mass, they have poor cognitive function, they get hormonal dysfunction, low sex drive, libido, infertility, nutritional deficiencies that are really widespread in the vegan community, omega-3, vitamin D, iron, zinc, and more are really common. And so we have to say, well, how do we create a diet that is inclusive of many different foods? but focus on the quality. So for example, if you make your pancakes with regular flour, bad news, right? If you make them with, like in the Pegan Diet book, there's a recipe for chai pancakes, which is delicious, but it's using almond flour and buckwheat flour. Now you can use regular buckwheat flour or you can even upgrade that to Himalayan tartary buckwheat, which is available through bigboldhealth.com, it's an ancient grain, 3,500 years old, higher in protein, lower in starch and sugar, more magnesium, more zinc. And what's really amazing is that since it was grown in such harsh conditions, very low water levels, high altitude, cold temperatures, poor soils, it's really robust. And that robustness, that stress on that plant, forced that plant to make its own defense system. And that defense system is phytochemicals. So the plant doesn't make phytochemicals for us, it makes it for himself. and so those phytochemicals in the Himalayan buckwheat are more than almost any other plant on the planet. There's 132 phytochemicals. Some of them are not available anywhere else. They have age reversing properties. They have immune rejuvenating properties. And so having pancakes from that flower is okay. And will I do that from time to time? Sure. Do I do it every day? No. But yeah, I'll make Himalayan buckwheat pancakes for a Sunday brunch with berries and you know, don't pour too much maple syrup on it because that'll screw it up. But you can actually include the right grains. So, what should we be eating? Ancient grains. I mean, one of the things that I've just shocked out in Europe, in particular in Germany, they make this rye bread and these dense whole grain breads. It's not made from flour, but made from ancient grains. If you stood on it, it wouldn't dent the bread. And, the only way you can cut it is with an industrial meat slicer, like even a knife, can't cut through it. You need these from slicing ham and then deli. Use those to cut the bread. And it's just so rich and good for you. So, it's not that I'm against grains. It's just the grains that we eat in this culture are so highly processed, pulverized, high glycemic grains, corn, wheat, those are the main ones. And they're deadly in the form that we're eating them. So, I think that's a huge factor for people to understand. Hey everyone, it's Dr. Hyman.

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Let'S get back to this week's episode of the Doctor's Pharmacy. We're all familiar with inflammation. You cut your finger, it gets a little infected, it gets red, swollen, hot, painful. Those are the signs of inflammation. And so that red, hot, swollen, painful happens not just on your skin, but it happens inside. And that's inflammation. And that's what drives autoimmune disease. So it's a final common pathway for so many diseases across the age spectrum, but it's a particular kind of inflammation. So heart disease is inflammatory, diabetes is inflammatory. autism is inflammatory, Alzheimer's is inflammatory, depression is inflammatory. Those are not typically autoimmune diseases. So inflammation can be of many types. The particular type that you get with autoimmune disease is where you create autoantibodies. Literally, you are attacking yourself. It's not something outside of you that's attacking you. You create an antibody response to your own tissues. So your body starts attacking your joints or your nerves and MS or your stomach and inflammatory bowel disease. or your thyroid in Hashimoto's, which by the way is super common, affects one in five women, one in ten men, half of them are not diagnosed and probably another three quarters are poorly treated. So that's a huge problem. But the ability for the body to recover from this is really important to understand because most people, when they get diagnosed with autoimmune disease, they're told this is a lifelong problem. You will always have this. We will have to manage it with immune suppressing medication. and hopefully you'll be all right. It's basically how it's done. And the reality is that we can not only improve the symptoms, not only stop it, but we can literally reverse it and get people to lose the diagnosis of autoimmune disease. You can say it's in remission, it'll come back. Sure. I mean, if you're eating gluten and you cut out gluten and your autoimmune disease goes away, you eat the gluten, it's going to come back. Right. So you have to kind of be aware of what are your triggers. And we're all a little bit different and need pay attention to what our unique differences are about what we need to avoid or what we need to do to manage the autoimmunity. But the truth is that once you heal things, the body is so resilient and robust. And so there's so much that we now understand about how autoimmune disease works, but it's not necessarily incorporated into traditional care yet. And what's really heartening to me is I see rheumatologists start to start to get into this. I was I was talking to one from UCLA, Cedar Sinai, and I was asked to speak to him because one of my patients also was seeing him. And I thought, oh, well, you know, it's going to be a challenging conversation. He's going to question everything I'm doing. He's gonna, blah, blah, blah, blah. I get on the phone, he's like, Dr. Hyman, I'm so glad to talk to you. I've been using your approach. I'm using anti-inflammatory diets with the traditional treatments, and we're getting such better results, way better than we ever got. And so I see the crack. in the edifice of our modern medical care system around autoimmune disease, it's just not fast enough for me because I see so many people suffer needlessly and we do understand in-depth inflammation. And so by using the model of functional medicine, we can help people to remove the causes of inflammation and then put in the things in the body that help regulate the immune system, whether it's vitamin D or fish oil, probiotics, there's a whole bunch of stuff that's on the positive end that we have to add in just so we have to take out the stuff that's causing problems, we have to add in the.

Things that help the immune system work better. Now, you give us a great sense of hope because the landscape is changing, but it's also changing slowly. And there are great functional medicine practitioners out there, but a lot of them, especially in the last year, they're not taking on new patients, they're overloaded, you're not taking on new patients, it's very challenging. And people are trying to get help and trying to navigate. So for the person that doesn't have access and is trying to figure out the steps that they can take, Can they still have hope that there's progress that they can make and stuff that they can do on their own with of course the support of their doctor that they have currently?

Oh my God, yes. I mean, most of the causes of autoimmunity can be managed without the help of a doctor.

So let's start off with the first one, which is diet.

Yeah, so the reason that I write the books that I write is to give people access to the science of functional medicine without having to see a functional medicine practitioner. And I can't tell you Drew, how many times people have come up to me and said, Dr. Hyman, you save my life. Last night I was going to dinner in LA and someone stopped me. He said, my dad read all your books. He had all these issues and autoimmune and he's cured everything and thank you. So it's not that you have to necessarily see a functional medicine practitioner to get better. Sometimes you do, but for the most part, if you start with food, because that's the biggest trigger, I would say, for autoimmunity, and do what I have written as the 10-day detox diet or we now call the 10-day reset. The book I wrote was designed to help people remove the inflammatory foods from their diet and add in the anti-inflammatory foods and to help fix their gut, help boost detoxification and help the sort of microbiome get back to normal. That alone can work for so many, many people. So essentially what I would say is, and there's a whole bunch of science looking at these kinds of approaches around diet. One of them is about inflammatory bowel disease. They call it the autoimmune paleo diet, which is very similar to the 10-day detox diet, which essentially gets rid of grains, beans, dairy, sugar, processed food, and it also gets sort of eggs, nightshades, and nuts, which can be triggers for some people. I don't remove eggs, night seed, nuts for most people because they're not, it's not that common. But if you really want to go extreme, you can do that. And then you add things back. And, and one guy came up to me at a lecture at Cleveland Clinic. He said, Dr. Hyman, I have rheumatoid arthritis, and I did your 10-day detox diet, and all my symptoms went away. Is that possible? And I'm like, Yes, if it was something you're eating. Now, if you have mercury poisoning or if you have a tick infection or you have mold exposure, mold exposure, you're not going to necessarily get all the way better, but you will improve and you still have to do the gut repair, which is really kind of easy to do on your own. Basically for most people, if you just do the 10-day detox diet for 10 days, you'll see whether or not what you're eating is driving inflammation. And for most people it is. That's the first step. and then there are ways to sort of navigate these other aspects around heavy metals, toxins, gut, and you sometimes may need to see a functional medicine doctor. But what I'm finding is now there are solutions that are coming up online. There's a lot of things that are affordable and accessible. You don't actually necessarily have to kind of go see a physician. Sometimes you will, but for most people, it's worth a try to start just with diet and lifestyle, exercise, stress reduction, sleep, some basic supplements are really helpful. So getting people on probiotics, getting them on omega-3 fats, giving them on vitamin D, simple things can make a big difference for people by just resetting their biology.

Now, most physicians, again, well-intentioned and sometimes maybe not well-intentioned, but most physicians well-intentioned, is well-intentioned. They see a lot of those recommendations, interventions as sort of soft recommendations, right? Nothing wrong with it, but it's not gonna do anything for you. Why is that? With all the education, with all the background, with everything that's there, why is it that still those are seen as soft when it comes to diet, sleep, and exercise and some of these other things that you just mentioned?

Yeah, it's astounding to me how much data there is, right? And physicians often hide behind the veil of what we call evidence-based medicine. And that is often a sort of deflection from having to do the hard work of looking at the data. Because if you go on PubMed and the National Library of Medicine and you search for diet and autoimmunity, exercise and immunity, sleep and immunity, stress and immunity, various vitamins, omega-3, vitamin D. You'll see there's plenty of data, but no one's put all the dots together. And that's what functional medicine does. So for people who are skeptical, I would say, look, just do your homework. You know, go look at the data. We need more, obviously, but there's a huge start. And we did a preliminary analysis that was done by the rheumatology department at Cleveland Clinic. We didn't actually look at the data, so it was sort of at arm's length. and we had a fellow from the rheumatology department look at our patients at the Center for Functional Medicine and then their patients. And Cleveland Clinic is, I think, the number two in the world in rheumatology. So they're not like a third rate rheumatology center. These are the best docs in the world. And in our docs at the center did better with those rheumatoid arthritis and psoriatic arthritis patients across a number of metrics that are standardized, validated, metrics from the rheumatology, they got better in terms of pain, inflammation, symptoms and so forth. So there's a there there. And I think there's a real awareness that there's a need to sort of incorporate some of these things. And I think when I hear these stories of other rheumatologists starting to come on board and other people thinking about how to actually use diet and lifestyle and how effective it is, it's important. And I think the reason we've sort of had this soft idea about it is because nutrition has been the stepchild of of medicine. It's like, well, okay, if you don't use much and you won't maybe get overweight and blah, blah, blah. But there really is, in a sense, that it's that powerful. And when you look at the science around food is medicine, it works better than a truck. Like, I. Listen, Drew, I. I don't care what the therapy is. If. If I thought a biologic was going to be the best therapy for this patient, I'd recommend it. I'm agnostic. I'm not pro or anti-drug, I'm pro finding out the root cause and addressing that. I'm pro creating health and seeing what happens. And when you do that, these problems just tend to go away and we don't have to go in that rabbit hole of medication. So I think we're kind of in this threshold moment where there's a real understanding that the microbiome is involved in so much autoimmune disease. And yet when you go to the rheumatologist or the neurologist or the GI doctor, they're not actually looking at your your diet. And it's just sort of stunning to me that they're not, or they're not looking at your microbiome. When you go, have rheumatoid arthritis, you go to the rheumatologist and like, let me look at your poop. Or when you go to the neurologist with the MS, they're like, let me look at your poop. And I remember, God, it probably was 25 years ago, I had an MS patient at Canyon Ranch when I was working there. And she said to me, Dr. Hyman, whenever my stomach and irritable bowel gets worse, my MS gets worse. I'm like, oh, noted. So you begin to go to these rabbit holes of listening to patients and listening to their stories. And the problem often with medicine is we come up with preconceived ideas about what's going on instead of actually listening to our patients. And most of what I've learned, I haven't learned a textbook. I've learned from, you know, being on the street, working with thousands and thousands of patients, doing thousands and thousands, maybe millions of tests, and seeing all the patterns in there. And I remember one guy who had severe ulcerative colitis. early on and I was like, oh, doing the four hour program or the time now, it's a five hour program to rebuild the gut and put them on elimination diet, all the things I thought should work, fish oil and this and that. He just didn't get better. He was losing weight. He was having bloody diarrhea. It was just miserable. And I said, well, you know, let me go back and look at what the causes are. So we, let's look at heavy metals. Let's look at all the potential immunotoxic things that are out there. And we found that his mercury was off the chart.

And I just detox him from mercury.

And his ulcerative colitis went away. Wow, powerful.

Now, you talked about diet. You mentioned a little bit about testing again. A lot of that testing is gonna have to happen with participation from a doctor, an integrative doctor, functional medicine doctor. Not all these doctors are trained in these tests. What about supplements? Where can supplements be a part of the picture? And in some instances, where may they not be helping when it comes to autoimmunity?

So I think they're part of the therapy package. But if like the same rule applies, if you're standing on a tech, takes a lot of aspirin to make it feel better. If you're if you've got Lyme disease and that's causing you autoimmunity, take a lot of vitamin D to make you feel better, right? Or fish oil or whatever. So when I think about immunity, I'm thinking, how do I how do I one help the body's own immune system do what it's supposed to do? And there are there are basic fundamental ingredients for regulating inflammation in the body. the biggest is the omega-3 fatty acids that come from mostly wild things, right? Wild fish, wild plants, wild animals. We don't eat that much anymore except wild fish. And that's primarily our source of omega-3 fats. And yet many people don't eat enough fish or they eat fish and it's got heavy metals in it. So it's problematic. So omega-3 deficiency probably affects 90 plus percent, maybe 98% of Americans. The second category would be vitamin D, which regulates hundreds of genes that control inflammation. So having adequate vitamin D is very important and it's been linked to, for example, MS. We know that people who have low vitamin D have more MS and it's more common in northern climates where there's low sunlight. So we know vitamin D plays a role in autoimmunity and inflammation. Probiotics are also extremely helpful because they help to normalize the gut. Now, if you have a bad overgrowth of bacteria, you can get into problems if you take probiotics, but it can be very helpful in normalizing the gut. And there's all sorts of anti-inflammatory probiotics. And, and that's a big rabbit hole. We can go down another conversation, but it's, it's, it's think about Precision probiotics. It's not just like, oh, take lactobacillus and that's it. There, there's really different probiotics that do different things for different conditions. And then, and then there's a class of compounds that are more kind of immune regulatory that are, that are phytochemicals. so there's a whole class of polyphenols that are plant compounds that regulate inflammation. For example, curcumin or turmeric, we've heard a lot about that. So that's probably the most potent one, but there's, there's many, all the proanthocyanidins from colorful fruits and vegetables, all the purple and blues and yellows and oranges and greens, they all have anti-inflammatory effects. And so I make sure I include a lot of those in my diet, and spices are great to use for that. So we start to begin to take those. So I, I, and I also look at ways to sort of regulate my gut health and keep my inner garden healthy. We're coming out with a product called Gut Food, which is designed to rebuild your gut. How do we feed our inner garden? How do we take care of that? And that's what the purpose of this new product is, how do we reestablish a healthy microbiome? And I am excited how people are going to do on that because it's one of those areas that is a little messy and there's not a lot of great simple solutions. So we really have the potential at any time to rebuild our gut. And that's another part of the supplementation is how do we create a healthy gut? And that includes vitamin A and fish oil and vitamin D and various nutrients like quercetin and, and, and even things like, like amino acids, like glutamine. So we sort of put together a.

Cocktail of things to help, help rebuild the gut. Now, you mentioned sleep earlier, and sleep is one of those things that doesn't get as much attention as it deserves. Now, you've done a whole free sleep masterclass, like completely free. People can sign up. We'll put the link to that in the show notes. It's Dr. hyman.com/sleep. But give us a couple high level components for sleep and its direct connection with recovering from autoimmune.

So sleep is one of those things that, you know, when I was in surgery and medical school rotations, they would say, well, you know, real surgeons don't need sleep. Right. And, and I, I've used up all my sleep credits in life, and it's, it definitely drives inflammation. You can feel it if you don't sleep. I remember working in the emergency room all night or delivering babies. And I would be so sore and achy and stiff. And I felt like my whole body was inflamed and I would have to go manage that by sleeping or I would go take a hot tub or something. And I think we understand that if you have sleep deprivation, it creates a cascade of dysregulation of the body, hormonal, cognitive and inflammatory and immune. And so sleep is among the best medicines. Why do you think when you have the flu or when you're have a viral infection, you tend to sleep a lot because your body requires that to repair and heal and to activate your immune response. So getting high quality sleep and enough sleep is super important if you have any kind of autoimmune disease and generally.

For everybody, by the way. Yeah, across the board beneficial, but especially if you're dealing with any kind of.

Disease like an autoimmune disease. I mean, particularly, you know, even in your brain, you know, you have a, a, a, a immune system in your brain called the microglia and the lymphatic system, which is like the lymph system of your brain. It only works at night when you're asleep. so to clear out all the waste and the garbage and all the things that affect us, we need sleep. We know that chronic stress. Now, we all have acute stresses, but the chronic unmitigated stress of our modern life and whether it's coming from the world we live in and all the chaos, whether it's coming from inflammation and stress that our diet causes, because our diet literally causes us to build more adrenaline and cortisol in our body, like high starch and sugar diets, whether it's our sedentary lifestyle, all these things drive our brains to not function properly. And so the stress response is something we know how to deal with. We know how to actually reset the body by activating the part of your nervous system that is the relaxation response. We call that the parasympathetic system as opposed to the fight or flight or freeze response. It's, you know, playing possum, you know, basically. And it's not just sitting on the couch watching TV, drinking a beer. It's actually a very active thing. So it could be meditation, it could be yoga, it could be my favorite or more passive ones like massage, hot and cold plunges. There are a lot of ways to access the nervous system to help reset it, to create a deep sense of profound relaxation that's physiologic and that helps you repair your brain. Because if you have chronic stress, it literally shrinks your brain. It shrinks the hippocampus in your brain, which is the memory center. so we know that chronic stress causes dementia. So just, just that alone can have a huge impact, those three things. And then there's a huge long list that goes on and on. But Dale Bredesen, who, one of my favorite people, he's a incredible neurologist who studied Alzheimer's and has used functional medicine to reverse, not just to stop or slow, but to reverse Alzheimer's in patient after patient. And he talks about this idea called a cognoscopy, which is how do we, we get a colonoscopy, but how do we measure our brain? function. Well, there are some really specific, simple online tests, neurocognitive tests you can do. There are ways of looking at brain imaging. There are certain lab tests and things you look at to see what are the threats to the brain. How do you, how do you assess the threats? And it's important because when you start to understand how the brain works, you can really play with it and see conditions reverse that you just never would see. I mean, I, I mean, I, I only wrote alter mind solution because I was treating people's physical problems. and as a side effect, their brains would get better. And I'm like, what happened? Like, someone, for example, would it be having panic attacks and anxiety and depression, and I would get their insulin under control and their microbiome under control, and they go, well, I don't have that anymore. I'm not depressed. I'm not anxious. Or they'd have bipolar disease and I did this and this and this and got better. Or they'd have ADHD or autism or Alzheimer's and they start to really improve or completely recover. I'm like, what's going on here? This is not what I learned in medical school. And so I began to really, through the inquiry of my own patients and their data and their experiences and applying functional medicine, was able to sort of map out how all this connects and all the things that affect the brain. And it's not just, it's not, it's not, it's not just the, the obvious things, but there's a lot of things that we can, we can dive into around infections and the microbiome and toxins and other things that affect brain health. So the fundamental things are easily accessible to everybody. And we all should think about not only how do we take care of our body and our weight and our heart risk, but also our brain health. And there's some very specific things you can do to do that.

Now, this topic is near and dear to you because you write in your book that not only were you focused on helping on your patients, but you were trying to help yourself. Your own brain broke. So I'd love for you to take us down your story. And also, while you go through it, help us look at the whole topic of brain-related disorders and how conventional medicine might see it and how functional medicine might see it.

First, I'll start with my story because it helped teach me so much about how the brain breaks and what to do to fix it. When I was in college, you know, a student, got into medical school, school was easy for me. I barely studied and my brain was just like a steel trap. And I remembered everything, could focus, pay attention, was happy. I mean, just my brain was good. I exercised, I ate healthy, I did all the right things. I did yoga. And then I went to China and got mercury poisoning, which I didn't know at the time, came back and got some other insult that tricked my system into really being sick. And all of a sudden, I went from completely functional to completely dysfunctional. I couldn't sleep. Even though I was exhausted and had chronic fatigue syndrome, I couldn't focus. It's like I had ADHD. I couldn't remember anything. I was got depressed. So it was like I had depression, ADD and dementia all at once. And I would literally be reading my kids a story at bedtime, and I couldn't understand the sentence. If I read it out loud, I literally would not be able to understand what I was saying. My brain didn't work. Or when I was talking to somebody, I would start a sentence, and I didn't know where I didn't really know where I was going. I couldn't finish the sentence. I was really damaged. And so through understanding my own biology and reverse engineering my way to health, I began to understand, you know, all the factors that affect brain health. And that's really why I wrote the ultra mind solution, because it's what I learned on myself, but it's also what I began to see on nearly thousands of patients.

Talk to us about some of those root factors that were going on for you. that might be beneficial for other people to hear? What was going on in your life that contributed you to being in that place in the first place?

Well, I had a bunch of stuff. I mean, I was in a crazy work schedule. I was working as a ER doctor after I came back from China, not sleeping. I literally was doing 15 shifts a month, which doesn't sound like a lot, but it's a lot. I was staying up all night, many, many nights. I was taking care of my two kids, my ex-wife was an alcoholic, and it was really a tough moment, a lot of stress, and a lot of work, and a lot of sleep deprivation. And then I would go to the emergency room and I would have an 11 o'clock to 7:00 a.m. shift at night, and I would drink a quadruple espresso, a giant chocolate chip cookie, and a half pint of ice cream, and I'd get in the car and I'd drive to work, and I'd last probably till five in the morning. Hopefully it was quiet enough I could take a nap. And I did that for years. And so between that stress, between the difficult stress in my life in terms of my marriage and also this mercury underlying mercury toxicity that then got tripped into full expression when I had a severe intestinal infection. That was sort of the straw that broke the camel's back and ended up just cascading into years and years of me trying to figure this out. And I got terrible diarrhea for years, SIBO, bacterial overgrowth. My muscles were getting damaged. My immune system was dysregulated. I started getting sores on my tongue, rash all over my body, autoimmune antibodies. my liver function went up. I mean, my whole lab test looked terrible, and I was a mess. And doctor after doctor was like, well, you're depressed. Take Prozac. Or you're anxious. Take Xanax. Or you can't sleep. Take Ambien. Or, you know, it's like I was. It was that. And I remember. And I started getting weird fasciculations and all kinds of weird symptoms, and my. My muscles were twitching, and my muscle enzymes were really high, which means my muscles were being damaged. And I remember going to Columbia and seeing these top neurologist who's an expert in this type of thing. And they ordered a test called the EMG, which is no fun. Essentially, they stick giant needles in your muscles and they then send electrical currents down them to see what's going on. And this guy was this old British doctor there who was running the test, and he said, oh, you have been benign fasciculations, which means your muscles twitch, but it's not serious. It's not ALS, which could, it could have been LA ALS and. And he goes, Off the record, this isn't normal. There's no such thing as benign fasciculations. You don't have LS, but it's something else. And I thought, ah, you know, and that was even before I figured out the mercury thing. I just didn't know what was going on. I was searching, searching, searching. So it took a couple of years for me to actually figure out the.

Mercury thing before I was able to get better. What was part of that turnaround process, which also was the introduction for you into the world of functional medicine? how did you begin to look at things differently and then start to treat yourself?

Well, I was always a little weird. I mean, I always, you know, I studied nutrition in college, and it was a yoga teacher before I was a doctor. I was interested in Integrative Health. They didn't even call it that then. And I was always exploring the edges, studied ancient healing systems, Chinese medicine. So I always had a different framework that I was coming from when I went to medical school. And then when I got a job at Canyon Ranch, it's right when I got sick. and I met a woman named Kathy Swift, who's a nutritionist there, and she's like, you got to come to this lecture from Jeffrey Bland. And I'm like, okay. And so I went to hear this guy speak, and I listened to him, and I thought, this guy's a genius, or he's a lunatic. And if what he's saying is true, it, it means that everything I learned needs to be re-examined questioned and re-imagined and I need to prove that to myself and my patients, so. I said, I'm gonna try it on. Cause if he's right, it's a game changer. If he's wrong, he's just a nut who's promoting a lot of stuff that's kind of goofy. And it turned out he was right. And the rest is history. And that's when we really started diving into functional medicine at Kenyon Ranch. We had a great incubator where we could spend hours with patients, I could dig into all these things, I could learn everything. They were willing to do stuff. And so it was really a great incubator. And then, I just kept going down that rabbit hole and. healed myself and started healing thousands and thousands of patients.

So what was one of the first things, and we're going to touch on your story, but these are also things that people can walk away with when it comes to their own story, too. So what was one of the first things that you did when it came to your diet? You were eating chocolate chip cookie, double espresso. You know, you had all this sugar in your diet. What was one of the first things.

You did when it came to your diet? Well, I, I literally had to do an elimination diet because the Mercury not only affected my brain, it affected my gut, which, by the way, they're totally connected. Right. There's called your second brain. There's more neuro transmitters in your gut than in your brain. There's more nerve endings in your, in your gut than your brain. It's really quite fascinating. And my gut was a mess. And so I developed leaky gut. I developed SIBO, which wasn't even a thing at the time. Small intestinal bacterial overgrowth, fungal overgrowth. I would eat anything, and my stomach would just blow up like a balloon. I, like, I had gas. It, it just wouldn't come out. And I felt like I was, had a, you know, like a, a giant sort of tire inflator. They just blew up my intestines, and it was painful and difficult that I diarrhea and undigested food in my stool. I was just kind of a mess. So I literally had to dramatically change my diet to just be able to tolerate any food. So I used turkey, broccoli, and brown rice for, like, a year just to kind of calm my system down. It didn't really help get rid of all my symptoms, but it just helped them not be so bad. And I, until I got rid of.

The Mercury, my gut couldn't heal. And it's not that you're necessarily recommending.

The turkey, brown rice diet to other folks. You're just talking about what you did. I'm just saying, like, my My system was so dysregulated, I couldn't eat anything without causing a rash or my eyes turning like a raccoon black or swollen tongue or my whole system was just messed up. And in order for me to just reduce my diet to the most simple foods that were not gonna be triggering reactions, I had to really simplify my diet.

So that's what you did then. If you were your patient today, what would you do for that person in that same situation when it came to the topic of diet?

If I had me as a doctor when I first started this, I would have been better a lot faster. I wish I, but like I literally had to crawl my way through knowing and, and by the way, it was really tough Drew because not only was I sick, but it was very hard for my brain to work. So I literally had to, despite having my brain barely functional, still try to learn and focus enough to try things. And it was really tough. It was really, really tough. It was like kind of like trying to like, get out of a very deep hole and a black hole. And it was tough because I didn't have the full capacity of my mind. So I started to learn things and I started to incorporate things. It was very slow. And it took me a number of years before I even figured out that I had mercury poisoning. And I ended up sort of being in a functional medicine conference, and I met a guy on a plane who was a naturopath, and he was he was like, well, come into my office, because maybe I can help you. I told him what's going on. He said, so he did this machine, this electrodermal screening, which sounds like total quackery, but it's looking at the bioenergetics of different meridians and different electrodermal electromagnetic frequencies in your skin, which are there. And he said, well, it seems like you have metal toxicity. I'm like, really? Okay. And then I went to my friend Mark David, and I said, I was just staying at his house. I'm like, can you do my hair analysis and see what's up? And he took a little hair. We sent it off. It was really high. And then I did a challenge test, and I found I had level that's, you know, I've done, I probably done 20,000 of these tests over the last 30 years and it was probably in the top 10, 20 tests I've ever seen of the worst levels. And then that was when I started to detoxify. But it was really tough because I didn't have a roadmap. I was just sort of figuring things out. We didn't even understand what SIBO was back then. We didn't understand a lot of things that we didn't know now. We didn't have a lot of the tools we have now.

So, that would probably be a lot better, a lot faster. so you mentioned mercury. You know, mercury is part of these environmental toxins that are out there, and it can come from a lot of different sources. We'll touch on that in a second. But mercury is is part of, you know, a ton of chemicals that are in the environment, like these puffs, forever chemicals that are there. We have mold that can be environmental toxins with all the flooding and the buildings that we have. Do you think that people are paying more attention to this topic? than you've ever seen before about how environmental toxins can play a role in things like brain inflammation?

Yeah, I think there's more and more literature about the role of environmental toxins in neurodegenerative diseases and autism and ADD in depression. So there's more and more science around this. So I'm very hopeful. But I do think it's still pretty much ignored. I think people aren't really trained in medical school to understand toxins other than acute toxicity. so chronic low level toxicity that eventually overwhelms your system is just not something that's even in the field of view of traditional doctors. So for example, I had this patient recently who had an autoimmune disease, but she had very high levels of lead in her blood and the highest level of lead I'd ever seen in any patient in 30 years. And it was causing all kinds of cognitive and also inflammatory symptoms. And, you know, the traditional doctors don't know how to look for that and test for that. They can check a blood test, but they rarely do that. But even if the blood test is normal, you can still have a lot of stored toxins if you don't have current exposure. So if you don't, for example, if you don't eat fish for three or.

Six months, your blood levels will be good, but you could have tons of stored levels in your body. I remember reading a New York Times.

Article about a group of soldiers that made their way to the Cleveland Clinic. Yeah.

And can you tell that story?

Yeah, well, you know, the Special Forces guys are really not WIMPs. You know, these guys are Navy SEALs who stand on ice water for three hours and, you know, one, run 100 miles. I mean, these guys are just super human. And it was a whole group of these guys who were really sick, and they were being kind of dismissed by the defense department and the VA. And one of them came to Cleveland Clinic in I said, well, let's look at your story. What's going on? You're cognitively impaired. You can't focus. You're depressed. You're overweight. Your metabolism is messed up. You have all these other symptoms. Let's just see what's going on. So I said, what do you do? He says, well, I'm a blast expert. I blow stuff up. And I teach other people how to blow stuff up. And we do it in enclosed buildings. And when you blow stuff up and you leave bombs and guns, you release lead mercury into the air, and they're in there in a closed space with poor filtration. They're breathing it in. So you do this long enough, you start to become poisoned. And they came in and they were poisoned and I was able to help these people get better. It was really pretty miraculous. And one of the story in the New York Times was about this one soldier who went to, I think it was Mount Sinai where they have the lead expert who uses a very specific technique. It's only kind of in research which looks at the bone lead levels, which is kind of the best kind of measure of total body lead. and this scientist, doctor, I think it was at Mount Sinai, said, look, we see this, we can measure it, but we never see it go down. But when these patients came back to me after being treated, not only were they clinically better, but their levels of lead in the bone went down. I've never seen this before. And of course you've never seen it before because most of us were never trained on how to detoxify patients from heavy metals. But when you know what to do, you can remove the metals. and these people get better. So now we have a whole group of people working with us from the Department of Defense and Special Task Force Dagger to incorporate these ideas into the VA and the Department of Defense healthcare system.

So before we get back into neuroinflammation overall and brain health overall, let's just put a button in the topic of mercury and lead. For most people, it may not necessarily be the first thing to look at unless if they're working with a functional medicine doctor. So most people who are listening who are wondering like, wow, do I have mercury? have led, it's an important topic to pay attention to. It's probably something that you need to be guided down the path of working.

With a trained practitioner who knows about that area. And, I think it's important to say, look, with brain disorders, whether it's the mood disorders, anxiety, depression, whether it's the, you know, tension of cognitive disorders like ADD and autism or the spectrum, whether it's the neurodegenerative disorders like Alzheimer's, Parkinson's, there are many factors that drive those problems. And, and you have to look at all of them. Mercury is just one, lead is just one. Those are final common pathways for multiple insults. So if you take 10 people with depression, there may be 10 different causes. For some it might be metals, for another might be a low vitamin D level, or the fact that they've taken antibiotics and screwed up their microbiome, or maybe it's because they're taking an acid blocker and have low B12, or maybe they have gluten intolerance and have dealt with antibodies against their thyroid, which causes depression. So there's a lot of ways to get to the same and disease. So I always say, just because you know the name of the disease, it doesn't mean you know what's wrong with you. Just because you have a label, it doesn't mean you know the cause. And the problem with modern medicine is what we call the name it, blame it, and tame it game. We name the disease. Oh, you have low mood, you're crying all the time, you're not interested in eating, you don't want to have sex, you can't sleep, you want to kill yourself. Oh, I know what's wrong with you. You have depression. But that is not the cause of your symptoms. Depression isn't the cause of your symptoms. It's the name of your symptoms. and then we blame the name for the problem. Oh, the reason you have these symptoms is because you're depressed. And the treatment is antidepressant. So we name it, blame it, and tame it, as opposed to what I call thinking and linking, which is where we start to begin to think about the cause, not just wait, you know, wait for people to sort of get on medication, see what happens. It's really a very important thing to understand for people that the same diseases can have many, many causes. And the same causes can create many diseases. So mercury could cause autoimmune disease, can cause gut issues, can cause depression, can cause Alzheimer's, can cause autism, you know, but not all cases of autism or depression or Alzheimer's are caused by mercury. So you have to kind of think about this kind of framework of one, just because you know the name of the disease doesn't mean what's wrong with you. Two, one cause can create many diseases, and one disease can have many causes.

So it's a really different framework for understanding human biology. Let's go back to one of the first things you talked about, which was sugar. help us really understand how sugar is so deeply tied into this whole field of neuroinflammation and poor brain health. What is it that sugar is actually doing in the body?

Okay, you got a couple of hours. I spent my life studying this. And I'm going to try to synthesize it. But sugar is not necessarily bad. If you have a cookie or if you have a little bit of this or that once in a while, it's not going to kill you. It's the dose that we have. We used to have historically 22 teaspoons a year as hunter gathers. That means if we got lucky, we find a honey, like a honey hive and we can get the honey or, you know, we might find some berries in the summer and we'd get some sugar. But historically, we really didn't have sugar as part of our diet. In 1800, we had 10 pounds of sugar per person, which was still a lot. And now, In 2020, we have about 150 pounds of sugar per person per year. So sugar, when you have it at that pharmacologic dose, is a poison. And it does a number of things. One, it screws up your microbiome. So it fertilizes all the bad bugs that create inflammation. Then that creates a leaky gut and that creates neuroinflammation. It also drives a process in the body called insulin resistance, which means your body is resistant to the effects of insulin. It's like the boy who cried wolf. you eat a lot of sugar and starch and your insulins go higher and higher and higher and the cells become resistant to the insulin. So you need more and more insulin. But the consequence of that increased insulin is that you get more fat storage in the abdominal fat and the belly fat. And those fat cells are not just there holding up your pants. They're very special kind of fat cells. They're not like the fat in your butt or in your thighs or whatever. They're highly active organs. They produce hormones. They produce cytokines. You've heard of the cytokine storm from COVID They produce all kinds of inflammatory molecules like IL-6, IL-1, and tumor necrosis factor alpha. These are very powerful inflammatory molecules that are coming from your fat cells. So that drives systemic inflammation throughout the body and you get neuroinflammation. Third, we now know that in Alzheimer's disease that there's a huge problem with glucose metabolism and it's insulin resistance of the brain for many patients. not all Alzheimer's is insulin resistance of the brain, but they're calling Alzheimer's type 3 diabetes now because of this impact of insulin resistance in the brain. So there's a lot of ways and pathways through which this causes a problem. And, and I'm not saying never have sugar. Of course I have sugar. It's just, what is the overall balance of your diet? Is this a staple? Is this a daily commodity that you're drinking for breakfast, lunch and dinner? I mean, America, we have sugar for breakfast, lunch, dinner. It's in our cereal, it's in our salad dressings, it's in tomato sauce. I mean, there's more, there's more sugar per serving of tomato sauce than there is in two Oreo cookies. So we've got to get kind of real and get all the hidden sugar out of our diet. When you look at, for example, diet studies in prisons or in juvenile detention centers, it's so impressive because simply swapping out healthy food and anti-inflammatory diet for an inflammatory diet in prisons causes violent crime by 56%. They had a multivitamin by 80%. In juvenile detention centers, these kids are violent. 91% reduction in violent behavior, 75% reduction in restraints, 100% reduction in suicide rates. In this group, which is the third leading cause of death in adolescent males, and you reduce it by 100% simply by changing the diet. Why does it work? It works because it cools off the inflammation in the brain. It's causing a disconnect between people's ability to have executive function, to have the grown up in the room, to have the higher self show up and say, Gee, maybe I shouldn't punch this person, or maybe I shouldn't cut them, or maybe I shouldn't shoot them, or, you know, maybe I shouldn't be in this violent oppositional life. And I think, I don't know how much it's contributed to the divisiveness in our society from the food, but I think it's way more than we think. And we've had David Perlmutter and his son Austin on the podcast talking about their book, which describes this phenomena and the science and the neurology behind the way our diet affects our brain and disconnects our limbic brain from our frontal lobe, driving violent and disruptive and divisive behavior.

Well, one of the unique things that's happening in today's world that is built on top of all the different things that you're talking about is that there are a lot of people getting rich off of creating this inflammation. We have the food companies that are getting rich by marketing and selling high sugary foods to the public. We have the news media that's literally making incredible millions of dollars, hundreds of millions of dollars by driving inflammatory style news, which drives inflammation in people, creates more stress.

And the advertising is all about inflammatory products, right?

All about inflammatory products.

Food, right?

Food. And many other factors that are out there too. So a unique thing that's going on in the world today that's important to highlight that has really never been there at this level is that through really the hijacking of media, and the use of media to grow these large companies, we now are able to spread inflammation so rampant and there's a very few and small group of individuals that are getting dramatically wealthy off the process. Yes.

I think a lot of stuff started off with good intentions that had bad consequences. In the post-World War II era, we needed to scale up agriculture to feed a hungry world, a growing population, to produce a lot of cheap carbohydrate starchy calories. And we did a great job. We did a great job. The average American has 500 more calories than they did in 1970 available to them to eat and they're eating it, which is why we're all so unhealthy. That was a good idea, but the unintended consequences have been devastating not only to human health in terms of diabetes and obesity. I mean, when I was born, there was a 5% obesity rate. Now it's 40. It's an eightfold increase in obesity in my lifetime. But we've also created unintended consequences for the environment and climate and the changes in our biodiversity and loss of species and the damage to the soil and our water systems because of how we're growing food. So we've created all these unintended consequences in the same way, you know, these food companies, we're not actually designing foods to drive all these problems. but we're locked in a system where the status quo is trying to be preserved so they can maintain their market share and their profitability. They're trying to navigate and figure out how to shift because culture is shifting, demand is shifting. We have a tremendous amount of money that goes into preserving the status quo, how we grow food, what we grow, the processed food industry, the marketing of the food. We spend billions of dollars from the food industry, get spent billions of dollars marketing and advertising bad foods. And the worse the food, the more money they spend advertising. And what's worse is it's hidden advertising now that's really a problem. And so these algorithms on these social media drive you into more and more of the same. So if you click on a conspiracy one conspiracy theory, you're going to get fed 10 other conspiracy theories. So I met these people that believe in all these weird, seemingly disconnected conspiracy theories because that's That's the universe they live in. So we live in these self-reinforcing information bubbles that are driven by algorithms. And the algorithms where they are designed to give people stuff they like, to show them if they want a nice pair of shorts or a bathing suit.

That they might like.

Again, well intentioned. Well intentioned, but the consequences now, we sort of let the genie out and it's out of control. And so even the people who develop these systems, I mean, I don't think Mark Zuckerberg is evil or had an evil intent to create more divisiveness and conflict and disruption in the world and violence. I think so. But I also think that the incentives now are to keep doing it and not to stop. So we have to start to look at what we're doing and create different forms of communications and media and social media that are not driven off of these algorithms that tend to cause more disruption, more divisiveness, and are incentivizing the wrong thing. I mean, one of the things that just shocking to me is forget all the ads on TV that kids see. $10 billion spent on all that. There's 500 billion ads, 500 billion ads in one year directed at children for junk food on Facebook. That's terrifying to me because the parents don't even know it. It's like you can say, oh, don't watch your TV kids or don't watch those commercials about Froot Loops, but it's all the hidden stuff. It's all, and it's all stealth. It's embedded in games. There's free games for these kids on social media and they play these games. But in the games, they highlight McDonald's or they highlight Coca-Cola or they highlight these different kind of food companies that are paying for it. And it's really co-opting these kids' brains. It's co-opting their own free will in a way. And I think that's what scares me more than anything, is the usurping of free will by this digital persuasion economy that's using algorithms to target us in ways that we It seems to be things that we like, but it spirals out of control. We have to get a way to solve that, whether it's inventing parallel platforms that people can use where that's not happening in social media platforms or whether it's regulation or legislation. This has gotten to be quite dangerous.

It's multifaceted, but most importantly, we have to have a dialogue about it. Even more important than that is that you, the person that's watching, the person that's listening today, you have to be the CEO of your health. You have to be the CEO of your family's health because ultimately, you know, regulation can do a lot, but it can only do so much. We, at the end of the day, have to drive education for ourselves and for our family. And that's what this podcast and your work is all about. So let's continue down the topic of inflammation. Patient comes to you today, right? What are the signs and what are the ways that the patient says, ouch, that are an indication to you that they have rampant chronic inflammation that is taken over and hijacked their body?

It's not that hard. Pretty much anybody with any chronic disease, inflammation is a player. And, and, and so whether you have the typical things that we understand as inflammation, like autoimmunity or allergy, or eczema or skin disorders, or it's the silent inflammation that's causing heart disease and cancer and diabetes and obesity and Alzheimer's. Anybody with a chronic condition is typically inflamed at some level. So my job is to then navigate and figure out what's causing it. Because when you get to the root of inflammation, you don't actually have to treat the diseases directly. I don't really treat diabetes. I don't treat Alzheimer's. I don't treat heart disease, I don't treat cancer, I simply change the biology of the body to normalize function to reduce inflammation and as a side effect these things go away. And I think that's a really important concept because if we don't understand that root cause medicine is the way we need to go forward, then we're gonna just be constantly spinning out on all these new drug treatments and spending billions of dollars to address this. I mean, they found out, oh, Alzheimer's is an inflammatory disease of the brain. So what do you have to do? Well, they did a whole study taking Advil. It didn't work and it caused all these side effects. Why? Because they didn't get to the root of the inflammation. Recently, a big study came out on aspirin. Doctors have been saying, take aspirin to reduce inflammation to prevent heart attacks. Well, if you read my stuff over the years, I've always said, bad idea. There are maybe some people who would benefit, but aspirin is not a side effect free drug and kills as many people as asthma or AIDS a year because of bleeding, stomach bleeding, gastrointestinal bleeding, brain bleeding, strokes, hemorrhage. So the recent study showed that, oh, sorry guys, we were wrong. You can't just take aspirin to reduce inflammation and prevent heart attacks because it's going to kill you. It's more likely to kill you than the heart attack. So stop taking it, which was a huge shocker because if you talk to any cardiologist, you talk to any primary care doctor, everybody was on board. And I was kind of shocked because I looked at the actual science that was supporting this, and I even look at the American College of Cardiology risk calculator. There's actually a calculator on the American College of Cardiology website to put in whether or not you would either get harmed or have benefit from aspirin. And most of the people who are on aspirin actually don't even qualify or didn't qualify according to the previous guidelines. Now there's a whole bunch of people who shouldn't even according to those guidelines be taking it. So I think it's backwards to say we're going to shut off inflammation with anti-inflammatories or immune suppressants. I mean, they're talking about using drugs like Humira, which is a $50,000 a year anti-inflammatory drug that's used for autoimmune disease for depression. Why? Because depression is inflammation in the brain.

The key isn't to shut off inflammation with the drug, is to get rid of the source of inflammation. How does traditional and conventional medicine, again, well-intentioned, how does traditional and conventional medicine look at and treat chronic inflammation? Like how do they, where do they think it comes from? And then how do they decide how to tackle it?

You know, it's just shocking to me that there really isn't a conversation about why. Oh, we know Alzheimer's is inflammatory. Oh, we know depression is inflammatory. We know heart disease is inflammatory. We know cancer is inflammatory. okay, so we need to give you anti-inflammatory drugs. There's no questioning of, gee, why in the first place is your immune system so pissed off? What's creating inflammation? And we know so much about it, it's not hard. It's our diet, our inflammatory diet, it's stress, it's our microbiome issues, it's triggers that, for example, might be from latent infections or allergens. or toxins, all these drive inflammation. So as a functional medicine doctor, my expertise is in being an expert in understanding toxins, allergens, microbes, stress and diet, because those are the things that drive inflammation. And so every individual has a different cocktail of things that are off. But my job is to figure out what is their particular triggers and get rid of them and then help their body, on the other hand, calm the inflammation down. so there's a whole bunch of things that cause inflammation, but there's a lot you can do to reduce inflammation. And it's not by taking Advil or aspirin or steroids or some chemo drug or a biologic that costs 50 grand a year. It's by the simple things that we know how to do. Food is medicine, anti-inflammatory exercise is medicine, anti-inflammatory sleep is anti-inflammatory meditation is anti-inflammatory yoga is anti-inflammatory. And then there's a whole bunch of supplements you can take to help reduce inflammation like omega-3 fats and vitamin D and probiotics and zinc and all the phytochemicals you can eat in your food that actually help reduce inflammation, all the spices and all the colorful fruits and vegetables. So there's so much you can do to reduce inflammation in the ways that we see. Now, if you have some latent thing, if you have a lot of heavy metals or if you have a terrible bug in your gut or bacterial overgrowth or you have some particular gluten sensitivity, you're gonna have to deal with those things too. But for most people, the basics just work so well.

Well, let's talk about those basics. You talked about food and you talked about some of the foods that help and we'll chat a little bit more about that. But what are some of the examples of the foods that might hurt? What are some of the foods that are out there that could be driving or at least supporting the process of chronic inflammation. And why do they support that?

Well, it's both what we're eating and what we're not eating, right? So we're eating too many inflammatory foods. 60% of our diet in America is ultra processed food.

And what is that? Talk about the stuff that you see on the shelf. What is an example? Because, you know, one thing I've realized and why I want to break this down is that if you go to Times Square, if you go here in Santa Monica where we're recording and you go up to most people and you say, Hey, do you eat healthy? Most people are going to say, Yeah, I eat healthy because everybody has a different definition of what it is. Or you ask somebody, do you eat a lot of processed foods? And most people say, no, I don't eat that much. A little bit here and there.

So describe it. What are we talking about here in ultra processed foods? There are a few commodity crops that are submorted by all our government supports from the Farm Bill that are the raw materials for processed food, corn, wheat, and soy. And they're turned into all sorts of weird products. corn has turned into all sorts of food additives and high fructose corn syrup. The wheat has turned into highly pulverized flour, which is highly inflammatory. The oils that come from soybeans and corn are often highly processed and inflammatory. So we're eating a lot of ingredients that are derived from these commodity products and ultra processed food that we're not even aware of. so when you read maltodextrin or something on a label, you don't know where that came from. That's a byproduct of corn from the, from a science project in the factory. When you eat high fructose corn syrup, same thing. So we're eating ingredients that are made from commodity crops that are basically the same three ingredients made into all sizes, color shapes of, of chemically extruded food like substances. So if you actually cover over the packaging and look at the ingredients, you literally would see the same ingredients on almost every processed food. We know with a few little tweaks here and there. And you can actually even tell what it is by reading the ingredient list. That's an ultra processed food. If you buy a can of tomatoes and it says tomatoes, water and salt, you know what that is. The ingredient list is, you know, 14, 15, 35 items. and half of them you can't pronounce, don't recognize and wouldn't have in your medicine cupboard or your kitchen cupboard, then you should not eat them, right? I mean, why should we be eating butyrate, hydroxytoluene or orthodextrose or all kinds of weird compounds that are not our natural food supply? So those are ultra processed foods and it's a huge component of our diet and it's highly inflammatory. So that's 60% of calories on average. And when you think of all the people who don't eat that much processed food, the people who are eating might eat 70, 80%, right? When you average a lot over all Americans, it's about 60%. And kids, it's even worse. It's 70%. 70% for kids. I think 67 is something. It's like terrifying to me. So that is really what we should be focused on not eating that's driving inflammation. and sugar and starch is number one, two and three. All the food additives, we eat about five pounds of food additives a year and they can be inflammatory. For example, all the thickeners, emulsifiers, things like carrageenan and gums that are used in processed food, they often have something called microbial transglutaminase, which is a gluten product that they use to hold the food together. And all these emulsifiers, they cause leaky gut. So these damage your gut. And when you have a damaged gut, then guess what? The floodgates open. Like we talked about earlier in the podcast, you start getting food proteins and bacterial proteins leaking into your bloodstream, your immune system gets all pissed off and it creates this vicious cycle of inflammation. So eliminating all that weird stuff is so important. If you read the label and you don't know actually everything that's on there and you can't pronounce it, you wouldn't.

Have it in your medicine cabinet, don't eat it. Let's talk about next, another category that is directly connected into inflammation, and that is sleep. And one of the biggest drivers of sleep that is affecting so many people is sleep apnea. Talk about sleep apnea and its direct connection to inflammation for most people and how it can increase weight gain and a whole list of other things that are there.

It reminds me this guy actually, sleep apnea is basically where you where you have multiple episodes of stopping breathing at night. So you'll snore, you might stop breathing for seconds or minutes, your sleep's interrupted, and it's often not diagnosed because you're asleep and you don't know you're doing it. Your partner might yell at you or scream at you or move to another room or put in earplugs. But you can actually use devices. One of them is a great little app. It's called Sleep Cycle. and it just records your sleep on your phone and you don't need anything. It's just you put your phone by your bed and you can have it on airplane mode even and it records your breathing and your sleep and your snoring. And so you can see and hear your snoring from the app. So I know my stepfather was a big snorer. He never believed it. He had severe sleep apnea and I literally recorded him with my cassette recorder back in the 70s because he didn't believe me when you can hear him just snoring like an elephant, you know? So, it's really common. It's often associated with being overweight, with having a thick neck, with sometimes structural issues, narrow palate, various things with your teeth. So, you can be thin in habit, but there may be airway issues. There can be central sleep apnea, obstructive sleep apnea, so it can come from your brain or from your obstructive airway. And what that does have those repeated awakenings to the night. to decrease quality of sleep, it actually causes insulin resistance, it actually causes diabetes, it actually makes you crave more sugar and eat more sugar and carbs. And you can't often fix weight issues or diabetes or obesity unless you fix sleep apnea. And it reminds me of a patient I had when I was at Canyon Ranch who was a lawyer. And he's like, look, I can't lose this weight. I'm 50 pounds overweight. Can you help me? I'm like, okay, well, something about your life. Well, I'm a lawyer. I'm like, okay. And so I get into how do you sleep? okay. And I said, well, I'm tired all the time. I said, well, what do you mean? Oh, yeah, well, I, I have to have a stand-up desk. This is before stand-up desks were possible, or, I mean, we're popular, like, you know, 25 years ago, because if I don't, if I don't stand up, I fall asleep at my desk. I'm like, okay, well, how about we check for sleep apnea? And he had terrible sleep apnea. We gave him a treatment for it, a CPAP machine, and he lost 50 pounds like that.

And his insulin resistance went away simply by sleeping.

So sleep is so important in regulating your metabolism and inflammation.

And, you know, we think of snoring as kind of like a funny thing, and we might hit our partner or laugh at our parent or grandparent, but really, as a dear friend of both of ours, Dr. Stephen Lin, a dentist down in Australia, and he says snoring is choking. So you have to think of snoring as choking at night. So if you know, if you're snoring or anybody else is snoring, you're choking. and you're choking and that prevents you from getting the right amount of air. And another version of that that's milder is breathing through your mouth. You've done some episodes on this. I've done some episodes on this. If you're breathing through your mouth at night and not through your nose, which is how we're designed to, that's also a sign that you might have a mild form of sleep apnea that needs to be addressed because it's directly tied into promoting inflammation in the body. Let's talk about another category of things that is a driver of inflammation and that's our sedentary lifestyle. Talk to us more about that.

Yeah, I mean sitting is inflammatory as we sit here and do our podcast. And that's why so much of us are struggling is because when we don't move, we are actually increasing the poor metabolic function that we have, increasing the risk for muscle loss, increasing the risk for insulin resistance, increasing risk for just chronic inflammation in our body. So being sedentary is a huge risk for inflammation. On the other hand, exercising enough, but not too much, right? If you over exercise, if you're an ultra marathoner or marathon runner, it creates more oxidative stress and inflammation in the body. But if you do regular exercise, you literally can reduce the inflammation in your body. And, and, and, and that's one of the most important things besides your diet for regulating inflammation. Well, sleep is really critical. I try to get at least eight hours a night. I try to prioritize sleep. I make sure that I create an environment that's healthy for me for sleeping, which is complete blackness. I use earplugs, night shades. If I travel to make sure the blood, all the noise, I try to turn off EMF and Wi-Fi in my room. I think I just was in the mountains and there was no Wi-Fi, no cell, and I have never slept deeper. So, I think there's a lot of things that are disrupting our sleep that we can use to modify our environment. In New York, I had bought this thing to go over our bed, which basically blocks out all cell signals and EMFs because we bought a meter that measures the electromagnetic waves. And in the apartment it said, Danger, danger, danger. It was like on the extreme, get out immediately. And you go to look at your Wi-Fi, there's like 50 Wi-Fi networks on there.

Right, especially in apartment complexes.

In New York. Plus the cell service. And when you put this special fabric over your bed and a grounding sheet, you go in there with your cell phone or your computer and you can't make a call, you can't get on Wi-Fi, it blocks everything out.

Do you feel comfortable recommending the company or- I actually don't remember. Okay, we'll see if we can dig.

It up and include it in the show notes. My wife got it all, but it was really amazing. It was like a party trick. You could go in there and everything was so neutralized. So I think Sleep is so important and I think there are many things that disrupt sleep. Our diet does, stress does, toxins do what it did for me, microbiome changes do, nutritional deficiencies do like magnesium. So there's a lot of ways to understand how to hack your sleep that are really important. So getting your sleep straight is super important.

So a couple more things on sleep. There's a lot more innovative products and trackers and other things that are out there for sleep. I'm gonna run through a couple and you tell me, do you use anything for sleep? tracking, whether that be some sort of heart rate monitor or anything like that. Yeah. So, there's a lot of things out there available.

There's all kinds of devices that track sleep. There's beds that track sleep. There's the Oura ring I've used that track sleep. There's Apple Watch that can track your sleep. There's apps that go along with it. There's sleep cycle, which just measures, you know, your breathing and ambient noise to detect sleep disruption. So, I think the technology for sleep sleep tracking is getting better and better. There's even home sleep apnea testing, which people can use to see if they have sleep apnea, which really affects your aging and increases insulin resistance, weight gain, and aging and stress response in the body. So it's important to make sure you don't have that. And I think using all these tools, you can kind of learn what works, what doesn't work for you, what disrupts your sleep. And I'm a shock.

Like if I look at my ring.

In my morning, if I drink alcohol.

When you say ring, you're talking about the oral ring.

Yeah. Yeah. When I look at my heart rate variability, when I look at my heart rate, when I look at my quality of sleep, my sleep score after I had, you know, a few glasses of wine, I mean, I'm not talking about getting drunk. I'm just talking about, like, a little alcohol. It messes it all up. I'm like, and that's the information for me. It says, oh, maybe I shouldn't be drinking, or maybe I should only drink occasionally. Or maybe, you know, like.

And so I really don't really drink much anymore. Occasionally I have a tequila, but I really.

I don't because I am like, oh, is that?

Especially as you get older, alcohol continues to affect you more and more and it puts more pressure on the body. So it's really something that we should consider. So in addition to alcohol, is there anything else that you've seen personally for you that significantly impacts your sleep quality? I've heard you talk about often you're in LA right now and we'll try to have an earlier dinner. Talk about that and how it impacts your sleep.

Yeah, of course. I mean, if you eat late, It definitely affects your sleep. And I was in Europe for a couple of months and it was terrible because they don't eat there till, the restaurants don't even open till 8:30 at night. And there are people eating at 10, 11, midnight and then going to bed. It's a bad idea because you need at least three hours before you go to bed for proper digestion. Otherwise you tend to store, you become more insulin resistant, you have higher cortisol levels, you might sleep as well. So having an empty stomach when you go to bed is a good idea.

Now, in the beginning of the podcast, you talked about some of the advances that you've seen when it comes to supplementation. Now, as you mentioned before, supplementation is supplemental. These are additional components that you add in on top of the base foundations of the right exercise, balanced blood sugar, sleep, and great quality exercise. So, talk to us a little bit about supplementation in the context of this whole topic of hacking your age.

So when I think about supplementation, I don't think about it randomly. I think about how do we optimize the systems in the body that affect aging? How do we optimize our gut microbiome? How do we optimize our mitochondria? How do we optimize our immune system? How do we optimize our detox system? How do we optimize our structural system? How do we optimize our communication systems, such as hormones and neurotransmitters? So I actually create a cocktail in the morning. that includes a lot of things that take a bunch of supplements. I can take you through it, but it's sort of my latest shake after I work out. I basically designed a shake that's anti-inflammatory, that's muscle building, that's gut rebuilding, that's mitochondrial boosting, and that is hormone balancing. And I do that all in a shake, believe it or not. So I put in not only high quality protein, so I use our Pegan diet protein powder. or Pegan protein powder, which is essentially protein, fat and fiber, no starch. I use goat whey because whey protein from traditional dairy might be a problem for me, but if I use goat whey, it's A2 casein. If there's any casein there, it's better tolerated and it works well. And then I put in adaptogenic mushrooms. So lion's mane, cordyceps, reishi, shagga, and so forth that help my adrenals, that help my stress hormones. I put in curcumin, which is basically anti-inflammatory liquid curcumin for my immune system. I put in probiotics. I put in something called Mitopure, which is a product that is derived from pomegranate that increases my topagi, which helps you clean up your mitochondria and rebuild muscle and mitochondria. I also put in a bunch of things that help my gut flora, polyphenols from a microbiome in addition to probiotics. So green tea, pomegranate, cranberry, and I put this whole and a few other things into the smoothie with some berries and some macadamia milk. And I literally have already come in revving up all the systems that kept me, helped me be healthy. And then I, then I focus on, okay, well, what else do I need to take? And so for me, I know that I've had mitochondrial issues, that my muscle enzymes are really high because I had chronic fatigue and mercury poisoning, and I have a muscle, a mitochondrial problem. and so I take a lot of mitochondrial supplements, CoQ10, lipoic acid, ribose, a little creatine sometimes, and carnitine, various compounds that NAD that help my mitochondria. And there's a lot of research where people are looking at one thing. We're gonna focus on NAD or NMN. This is the cure to aging, nonsense. You have to look at everything. And once you've cleaned up everything, then these things will help. But if you're mercury poisoned or you're severely insulin resistant or you're not exercising and you take a little NAD, it ain't gonna do much, right? It ain't gonna do much. You have to make sure that you build a foundation and these things will help as sort of value enhancers.

Not that they can't help, but it's gotta be holistic.

For me, the key to understanding aging is to understand what causes aging and how do we optimize these fundamental systems in functional medicine? That's really the key to healthy aging. not just focusing on one thing, which a lot of people get, oh, I'm going to focus on inflammation, or it's the microbiome, or it's the mitochondria, or it's insulin, or it's nonsense. It's all of it. And then you have to find out for each person what's the worst things that they have that we need to address. But in general, you have to look at keeping all these systems optimized. So I'm not treating disease in myself. I'm looking how do I leverage what I know about how the body works to optimize the function of all these key systems. my energy system, my detox system, my gut, my immune system, my structural system, what I made of my hormones and my communication systems, my detox system. And it's really food, it's exercise, it's sleep, it's stress reduction, it's the right supplements. And then it's making sure you get.

Rid of from your life all the things that disrupt those systems. Now, you went to go visit one of these Blue Zones and you're friends with the original author of the Blue Zones. Dan, yeah.

Dan, yeah.

And one of the things inside of the Blue Zones is also about finding our tribe.

Yes.

So in addition to all the things that you mentioned, a big part of this is actually connecting with the right people to support us in our journey and to lift us up. Soul friendships.

Yeah.

Talk a little bit about that and how that's evolved in your life and how did you create the friend group that you have now?

So just to take a step back a little bit, you know, when I said, what are the ingredients for health, you know, And we think, oh, it's food, it's exercise, it's sleep, it's stress reduction, et cetera, the supplements. But what we find is that there are more intangible things that may be as or more important, like meaning and purpose. A study came out in JAMA last year that if you had higher meaning and purpose in your life, you live longer. Many, many studies have shown that if you actually have a strong community that you live longer. If you're part of a bowling group or a knitting group even if you eat crappy, you live longer. And one of the best studies was in Rosetta, Pennsylvania, where a whole group of Italians came over from a small town in Italy and they basically relocated to Rosetta, Pennsylvania. But they kind of adopted the American diet, but they didn't get all the diseases that Americans get. And when you looked at that community, there was this really thick fabric there. They all participated wealthy, poor, all the whole across the spectrum. were all friends. They gathered, they celebrated all holidays together, birthdays, weddings, anniversaries. There was a really profound community. And in Sardinia, that's what you see. Nobody's alone. Everybody's got community, family, connected, celebrate together, laugh together, sit and chat together. There's a deep sense of community and connection. So we know from the science, it's not just an abstract idea, that the power of community connection, meaning and purpose are important as ingredients for longevity and health as almost anything else. And so I think food and that is probably the two most important things and you just see how powerful it is. And for me, and I've been really blessed to have so many good friends in my life, so many different kinds of tribes which are all intersecting and I feel so seen, loved, taken care of and honored in my friend group that I just feel like it just, it gives me a sense of of safety and possibility that if you're alone and isolated, you can't get. And when you look at the risk for disease and you're looking for the risk for death, it's not necessarily what you think. It's not smoking, it's not bad food, although they are big. Even more important is loneliness and what we call agency. And one of the most shocking studies I ever saw was looking at, we talked about the social determinants of health, which is sort the things that people are exposed to in their communities that make it difficult to be healthy, whether it's poverty or lack of access to healthy foods or various kinds of stresses or living in communities where there's a lot of pollution, right? Whether you're living next to a factory farm in North Carolina, whether you're living in the Bronx and, you know, exposed to tremendous waste plants that are polluting your air and causing asthma and kids and so forth. So what we found is that, is that if your locus of control is gone, if you feel like you have no agency over your life, if you feel like you're powerless in your life, which is a lot of people in America, that that is a bigger risk of death than anything else. So how do we build a society in a culture that's less individualistic and more focused on community and love and connection? It's one of the the greatest things about America, but it's also one of the worst things. The pursuit of individualism and individual happiness at the expense of the collective happiness, at the expense of community. And I think that has really been the downfall of a lot of America in this sort of modern day where we're really not focused on how we build a better community, how we build a better society, how we help each other, how we can support each other. we've lost that. We've lost tribe. And, you know, I just think of my own family. My, my daughter's in Utah. My son's in New York. My niece is in Texas. My nephew's in California. I mean, like, it's not easy. And, you know, even my friend group, I mean, a lot of my friends are all over the place, and everybody's kind of mobile and moving. And, I mean, Sardinia, you know, Julia, who was 103 months, she was made sure to tell me she was 103 months. Like, she's five and three quarters that, you know, they lived there for their entire life. They know everybody, they see everybody, they have a sense of optimism and hope and connection and belonging. It's so powerful and that that's what we're missing.

And it's not that we want to return back to that lifestyle, which has its own limitations. It's just that we have to ask yourself, how can we create a version of that and that connection and still have the advantage of being able to live where we want to live. It just means being intentional about it.

Yeah, exactly. Every week I gathered all my deep old men friends to gather and we gather in a men's group online because of COVID I was speaking to a guy last night. It made me really sad. I was at a weekend where we were with a group of people and reimagining the future. How do we reimagine society, the economy, spirituality? And it was beautiful, deep conversations. There was one gentleman there who said, you know, this is so great. We're having connection and conversations. And I was sharing how, you know, in my community, we have intentional conversations around dinner. We create a container to have honest, deep conversations with each other. So we get to know each other, we get to hear the truth, we get to tell our stories, we get to be seen, we get to hear others. And he's like, I mean, this is great here, but I don't have this in my life. We have social events, but they're just very superficial. I'm like, well, you can change that. You can be the activist in your little friend group to start to have these conversations, to create supper clubs or dinner parties where there's a theme or an intention, where there's intentional focused conversations. And it's nourishing. It allows you to actually feel more connected to the people in your life. And it's available to all of us. Maybe you don't have it. You have to create it. I, you know, when I go somewhere, I invite people over. I was in Hawaii last year. I didn't know anybody, and I started meeting people, inviting them for dinner. We started having deep conversations, and you.

Can build it wherever you are, but it takes an intentionality. It just takes one person to raise their hand and say, Hey, I need this in my life. There's chances are that other people need this too. Let me get everybody together. Here in Los Angeles, when I first moved here, I didn't know anybody because I grew up on the East Coast and almost Six and a half years ago, I started a weekly men's group. We call it Man Morning Thursday, because we go on a walk every Thursday morning. And it was a bunch of other people, individuals, other friends that all moved to Los Angeles around the same time, and we just go on a walk. We walk and talk about things that are in our life and things that are on our mind. And something so simple makes a profound difference in my life. Okay, I want to shift from community, which is a super important topic, community and relationships, and I want to talk about innovative therapies. This is a whole area that maybe a little bit of a disclaimer should be put out that this is emerging. It's not always accessible to everybody, but it's worth pursuing and talking about. So you've been interested in a whole classification of innovative therapies as it relates to just overall performance in the body, but might also support the topic of aging. What are some of the things that you've been into that have supported you and might provide support for other people that are out there.

Yeah.

I mean, there's a whole field now.

Emerging called regenerative medicine, which is how do we regenerate our biology, regenerate health? And, and there's a whole cocktail of things that you can do in the context of regenerative medicine, which I think I see is just another extension of functional medicine. So functional medicine asks the question, how do we create health? How do we optimize health? and how do we work with the body rather than against it? And so what are the kind of therapies out there that are not treating a specific disease, but that are enhancing function? How do we optimize the way the body works? How do we get the systems in the body to heal? How do we activate our own healing and repair systems? The biggest pharmacy in the world is the one between your ears, right? We have the power to radically change our health through the power of our minds, through our lifestyle, through a lot of things that actually we have access to very easily that we can upgrade our biological software at any age, whether it's simple things like time-restricted eating or intermittent fasting or there's more advanced therapy. So, I'm just going to sort of talk about what are the, I think, the low-hanging fruit in terms of therapies that are out there that can be started to incorporate in medicine that will help to increase our health and increase longevity. the first is not only what we eat, and we covered that pretty well, but it's when we eat. And taking time for your body to have rest from food, even for 12 hours, is so important for your body to repair, clean, and do all the work it needs to deal with the consequences of eating all the time. We used to call it breakfast. eat dinner at six, you have breakfast at six or seven, that's a 12 hour fast. But now, because of the snacking culture, because of food marketing, because of the ubiquitous nature of food, because of the fact that we're all addicted to sugar and carbs and have cravings and can't control how much we eat, we tend to eat late and we often will eat as soon as we wake up. And so we don't give our bodies that natural rest. So the strategies around activating all the healing systems in your body that help longevity are all doing the same thing, whether it's a time-restricted eating, eating within an hour window, whether it's an intermittent fast, a 24-hour fast once a week or 36-hour fast, whether it's a fasting and mimicking diet, which is a short time of five days of calorie restriction for, for example, 800 calories a day, whether it's more prolonged fast or whether it's a ketogenic diet, they all do the same thing. They activate the body's repair and healing system. So what do they do? They decrease inflammation. they increase your antioxidant systems, they boost your mitochondrial function, improve the efficiency and function of your mitochondria, and upgrade your energy systems. They increase stem cell production, they build muscle, they build bone, they reduce stress hormones like cortisol, they increase growth factors that repair factors in your body that help healing. So there's a lot of different ways to get there, but these dietary strategies around when you eat, are important is what you eat. The second is a number of therapies out there that are, and the supplements we're gonna kind of leave to one side, 'cause a lot of people are working on interesting supplements to help around NMN and AD and so forth. But it's certain therapies that help to activate the healing system. So what do I think are the most exciting ones? One of them is ozone. Ozone is also a therapy that activates the body's healing response. You know, you say, what is ozone? Sounds crazy, isn't it dangerous? You breathe it, you die. Yes. if you breathe, if you go online and you go to the FDA website and you read up on ozone, it's gonna say it's dangerous, don't do it, it'll kill you. Why? Because if you breathe it, it will kill you, right? If it's in the ozone layer is destroyed and we're all breathing more ozone, it's bad for our lungs. But guess what? Water will also kill you if you inhale it. It's called drowning. It doesn't mean water's not good for you. It just means you got to know where to put it. Same thing with ozone. So when you mix it with your blood and you put it back in your body, In it in one that kills all these latent infections, so it's great for Covid, for ah, for tick infections, viral infections, all the stuff that we have, but also it also is hormetic, and hormesis is the simple idea that what doesn't kill you makes you stronger. So when you lift weights, you are tearing your muscle fibers. Sounds bad, but actually it makes your muscles stronger. Right? If you exercise and do high intensity training, it's a stress on your mitochondri, but it makes them come back stronger and smarter. so hermesis is basically when you stress your body with something, it kind of rebounds and creates a healing response. So ozone does that. It's an oxidative therapy that creates oxidation, which we think is bad, but what that does is it activates your body's own antioxidant system. It shuts off inflammation, it turns on your anti-inflammatory system, it boosts your mitochondria, it increases your circulation and decreases blood clotting. So it has all these incredibly beneficial effects. that will help with aging and longevity. Also, there's other therapies like hyperbaric oxygen, which increases blood flow and oxygenation to tissues, and is also an oxidative therapy. There's exosomes, which are stem cell derived compounds that are essentially little tiny packets of the healing factors that are in stem cells that are extracted, grown in the lab. So instead of having to suck your bone marrow out, instead of having to do a fat liposuction to spin your stem cells down, and getting, however, I might be getting 62-year-old stem cells. I want to get fresh young ones and you can't really get stem cells from somebody else because your body will reject them. So exosomes are really powerful because they're grown in a lab from placenta or other sources and they actually are extraordinarily healing and reparative. And then of course there's other therapies besides ozone, exosomes, hyperbaric oxygen that might be helpful that we're just learning about. One of the things that I really am fascinated with is the use of things that enhance neuroplasticity and neural connectivity. And there's a lot of research in the psychedelic space now looking at how, for example, microdose psilocybin, which is magic mushrooms, will actually reduce the symptoms of Alzheimer's or Parkinson's disease that helps repair the brain. And that it's incredibly helpful for depression. So a lot of things out there that may be coming down the pike that we're learning about that can help to regenerate and repair and heal that are supporting the body to age well as opposed to simply just, you know, relying on the normal stuff we rely on.

I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in.

Hey everybody, Hey, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com/picks to sign up. That's drhyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger, longer.

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