The 5 Secrets To Looking Younger (Do This Today) | Mark Hyman

The side effect of practicing functional medicine is that people look younger and their skin gets better and all these external problems go away.

Give us three things that are deeply connected to looking young on the outside but by starting on the inside. So what's one of the first ones you want to chat about?

Well, they're all related to ways to lower inflammation and help repair and rejuvenation of your entire body including your skin and your face and so forth. The first is food obviously. So what you eat plays an enormous role and we'll talk about what to not eat and what to eat but the key thing is you want to have high levels of certain nutrients whether it's vitamin C, vitamin A, zinc, biotin, omega-3 fats. These are critical nutrients, the carotenoids that help produce healthy skin, healthy collagen, reduce inflammation or antioxidants. the next is, is hot and cold therapies, because our skin is an excretory organ. It's the biggest organ in our body. So when you sweat, when you, when you actually create this experience of your body in these extreme temperatures of extreme heat and cold, and I'm staying in a place now where literally I'm doing it twice a day. They have a sauna and a cold plunge. And it, it's amazing. When you come out, your skin looks revived and fresh. You excrete all the sort of superficial toxins, deeper toxins.

And your skin just feels healthier. Actually, you can like feel it and it just feels healthier.

It feels healthier, it feels tighter, it feels healthier. It feels like your skin can actually breathe. Yeah, exactly. And we're supposed to sweat and we're supposed to excrete those things. And then the cold also resets your autonomic nervous system. So your skin is innervated by nerves, brings blood flow and circulation. So it helps to revive your skin. The third is movement, exercise. Plays a huge role too for the same reasons. It actually increases circulation, lymphatic flow, lymphatic function. the way that your lymph system works, which is the detoxification system in your body that clears out all the fluids that are full of metabolites and inflammatory compounds. It removes them from your body and things that aren't even in your circulation from the tissues, puts it into your lymph system, then it dumps into your circulation so you can detoxify it. And exercise is the only way to really activate that. Diet helps too, but exercise is super important. and I think also just, it helps with reducing inflammation and it can activate your antioxidant systems. It can help with excretion of toxins from your skin. It can just overall help your overall sense of wellness and well-being. So I think from that perspective, it also makes you feel younger too.

We had a gentleman on your podcast and mine, Dr. Ben Bikman, who is one of the world's experts in insulin resistance and all the pathways of insulin. And one of the things that I learned about from him when it came to food and how food can age us is that I had shared with them that, you know, my background's Indian, I'm South Asian, and a lot of South Asians, I noticed this when I go to India, they, as they, and this is, it used to be if you were a lot older, but now I started seeing it on some of my extended family members who are in like their later 20s or 30s.

Yeah.

They start to develop these dark patches under their, their eyes. And there's a lot of also what are called, like, these skin tags, if you've seen individuals with those.

Yeah, and it's called acanthosis nigricans also, which is this problem you get from eating too much sugar.

Sugar and refined carbohydrates. So that's one very practical way. If we're talking about reduction of dark circles under our eyes, which can be caused by a lot of different things or influenced by a lot of things. And if we're talking about keeping our skin healthy and just avoiding skin tags and little patches and other stuff, our food actually significantly contributes for the better or for the worse towards those things.

Yeah, absolutely.

Break down some of the other categories on food. Let's talk about like omega-3 fatty acids. You know, what do people not understand about having the ideal omega-3 to omega-6 ratio and how it influences appearance?

Well, you know, we are what we eat. and, and we're, we're basically creating the building blocks of our structure from the food we eat. So if we eat junk, we end up having junk molecules building our tissues.

Right.

Whether it's the fats we eat or the proteins we eat. So what's interesting about fat is that, you know, there are a lot of different kinds of fat. I wrote a whole book called eat fat, get thin, where I go way into detail about this. But, but essentially, the, the majority of the fat in American diet is hidden fat in processed food in the form of refined soybean oil. It's about 10% of our calories, a thousand percent fold increase since the 1900s. And these can be very inflammatory and when consumed in large amounts, they're easily oxidized and they're not really what we should be built from. Omega-3 fats, on the other hand, and saturated fats are the better fats for our biology. They're the things we've actually evolved eating. and help construct better cells, better membranes, better skin. So one of the things, if you're Omega-3 deficient, it's really common to have dry patchy areas on your skin to have dry skin, pale skin, flaky skin, dry hair, brittle hair. There's a whole bunch of clinical symptoms I look for, and I can actually tell from someone's actual physical nutritional exam whether they're deficient in Omega-3 fats, hard earwax for example is another clue. So we can begin to see that we need to eat the right fats so that we can actually build our tissues from the right substances. And these Omega-3 fats are very anti-inflammatory, whereas the Omega-6 is in the wrong ratio, out of balance, are inflammatory. We need the balance. It's not inflammatory bad or good. We need both. Omega-6 fats are, there are essential fats. Linoleic acid is an essential Omega-6 fat, Omega-3 fats are essential. You have to get them from the diet. But you don't need the volume we eat now. We used to eat maybe one to one, Omega-3 to six or two to one, Omega-6 to Omega-3. I had a patient who saw her picture, Janice, we always talk about her. She was red in the face, super inflamed, chronic illnesses. And I got her lab tests, which I was just shocked that I'd never seen such an abnormal ratio of Omega 6 to Omega 3, it was 20 to 1. I was like, whoa. So, you know, my patients usually are pretty self-selected and they're already coming in, like, pre-cleaned up. They're already pretty good on their diet. They're already exercising. They want the, the value add that I can provide in solving complex problems. But occasionally I get what I call a virgin patient who's never eaten a vegetable in their life, and you just see what they're eating and the processed food and what the effect on their health and their skin. It's amazing. I mean, the The side effect of practicing functional medicine is that people look younger and their skin gets better and all these external problems go away.

I want to talk about one of the foods that was on your list when we were just jotting a couple of notes that people don't always think about when it comes to beauty, and that was organ meats. Talk about organ meats and why that was on the list of foods you included.

Yeah, organ meats are something weird, like why would you eat kidneys or liver or heart or Brain. My mother used to feed me cat's brain when I was a kid. That's what it's good now with the- that's intense. Yeah, mad cow disease. But anyway, I think they're an unappreciated source of the most nutrient-dense food on the planet. And I encourage everybody listening to go to their computer after this is over and Google liver and nutrient density and compared to vegetables. And you'll see in the graph side by side, liver looks like the most powerful superfood ever invented on the planet, whereas the best kind of plant-based food, like high nutrient density broccoli or something, looks like a very poor second cousin compared to the liver. It is because these organ meats contain the highest levels of nutrients and medicinal compounds that are essential for our health, like vitamin A, omega-3 fats often, and they're really rich sources of nutrient-dense food. So I think people miss out on that. Now you wanna make sure you're eating organic. And when I was a kid, my mother, we were very poor. We lived in a one-bedroom apartment in Queens. She was a teacher. She made like $7,000 a year. And she would make fried chicken liver with onions and over rice. I thought it was like a gourmet meal 'cause I loved it so much. But that was our dinner 'cause it was so cheap 'cause nobody wants to eat chicken livers. But get organic chicken livers. It's a good thing to add to your diet. and it's good for your health and your skin. And if that grosses you out, they actually have companies now like Paleo Valley that make organ meat supplements. Right.

Or even better than organic would be like if you can find pasture raised. Regenerative, right. Right, regenerative or pasture raised, which again, it's not always accessible, it's not always out there, but we highlight the different options that are there. Still, if the organic chickens are mostly eating organic corn, right, so their makeup is gonna be a little bit different. But again, we do the best that we, We possibly can. So I'll come back to food in a second, but I'm really curious, especially with you being out there, shout out to our friend Jeff, who is at One Commune, and you're staying at their retreat center here in Los Angeles, up in Topanga, and they have a sauna set up. They host retreats there. We'll link to their center in the show notes, and you can check it out if you want to. But you're staying there right now, working on your next book about longevity. Practicing what you preach. So give us the minimum viable dosage when it comes to hot and cold. What have you seen from the research and what are you doing while you're there and also while you're not? Because you're often traveling. So how do you get advantage of the hot and cold treatments when you're.

Traveling or popping around at different places? Yeah, well, I'm super spoiled right now because where I'm staying, it's just this giant cedar cold plunge and there's also this beautiful barrel sauna which quickly heats up. So basically my routine is I'll wake up, I'll write for a little bit, I'll work out, sort of fast, sort of do like an intermittent, I mean a time restricted eating, and then I'll turn the sauna and I'll go in the sauna and I'll stay in there pretty much until I can't stand it, 10-15 minutes, and then I go in the ice plunge as long as I can. Now, what science says is just fascinating about this. With saunas, it actually activates your innate immune system, it activates heat shock proteins. So a lot of what happens with our skin is the degradation of proteins, And heat shock proteins really help to repair and refold proteins in ways that actually make them back to normal. It also helps you detoxify your skin and get rid of all the sludge and stuff that builds up over time if you're putting stuff on your skin or if you're not sweating, so sweat really helps. And so it's really an anti-inflammatory treatment. It also helps reset your autonomic nervous system, so lower stress means lower cortisol. cortisol causes your skin to thin and to break down. And the cold treatments also are really amazing because they reset your autonomic nervous system and they help to actually activate what we call brown fat, which increases metabolism and your overall metabolic health. And so combining those two together will actually extend life and help you look better. Now, in Russia, I mean, in Finland, they have, I think, enough saunas for everybody in Finland to go on in the same time. to be in a sauna. And their control group, because they were so into saunas, was basically, you know, people who only get it once a week versus five times a week. And a sauna has been shown to actually improve cardiovascular fitness, improve cognitive function, to improve heart rate variability, to help with detoxification, to help with innate immune function, to help with reducing inflammation, these heat shock proteins. So there's so many scientific benefits that have been proven. and I think it's a great longevity strategy. And then when you're on the road.

You know, what I'll do is I'll tell you. And sorry, before you talk about the.

Road, how long are you doing each of those? As long as I can stand it. As long as I can stand it. Basically, I go in to the, depends on how cold the plunge is, but how hot the sun is. But usually 15 minutes in the sauna.

And then I'll try to stay in the ice place.

How many hours cold it is for two or three minutes. Right. Temperature for both is a big part of it. So if you do a 40 degree ice plunge, it's even doing a 50 degree ice punch, right? I was in one the other day with ice cubes in it. That was like a minute. I could handle a minute with ice cubes. People build up to it. But then I got really cold after it and I needed some chicken soup. Sure, sure.

And for anybody who's listening, obviously follow Documented Protocol. You had Andrew Huberman on the podcast. He's got a few. Wim Hof, you had him on the podcast. He's got a few as well. Build up your tolerance. But if you would say minimum viable dose, and then also minimum viable dose when you're on the road of how you eat.

I think, you know, 10-15 minutes on a hot sauna, if it's in front of a half an hour and at least a minute in cold plunge, ideally.

You can do about three, two, three, four minutes, five minutes.

Yeah, and then how many times a week? If you can get in even once a week, twice a week? Yes, I mean, I think more is better. So I try to do it every day. If you can't, you know, two, three times a week is good. People don't have the availability often, but there's hacks, right? actually take an extremely hot bath, that helps. And then you can go in a cold shower. Most people don't have a problem with that. Most people have a bath and most people have a shower. So, another thing you can do is wake up every morning and take a nice cold shower, which I did when I was in Vermont for a month by myself, which was quite interesting. I skipped, I quick coffee and went for the cold shower and I'll tell you it worked. And then I was traveling and I friend had a cold plunge. I did it every morning when I woke up. It's the best way to wake up.

You're like, whoa, okay, I'm up now. Yeah. I don't have a backyard, but my brother-in-law, Dr. Neil Patel, who's a cardiologist down in San Diego, he got for his backyard a little plastic barrel. You dump ice in it, fill it.

Up with water, and then that's like your cold plunge. Yeah, you can get those metal troughs that you use for like feeding cows and horses and water. Totally. And then my friend bought an ice.

Machine and basically filled it up with ice and put water in and they.

Just give you ice plunge. And you're not just doing it for your looks. Like you actually feel good after doing it. Yeah, I mean, it's not, I'm not doing it for, for how I look. I'm doing it because it's the most powerful stress reset I've ever experienced. Literally just clears out all the stress. I think I'm tired and actually not. It's the accumulated stress of working, thinking, writing all day, sitting in the chair. It's just stressful. It's the normal stress. And I'll do something like that. All my energy will come flooding back. I go, wow, this is the best magic trick. So if I'm tired or I'm a.

Little stressed, it's the greatest way to to a reset. That's great. That's fantastic. Let's go over to movement. You know, everybody has a different angle on movement, and we've covered movement a few times in this podcast, but tell me about movement and its relationship to beauty from the inside out.

Well, you know, one of the things that ages us most is, is what we call the hallmarks of aging. And I talk about this in the book, but there's a whole series of underlying breakdowns that happen in our biology as we age that drive accelerated inflammation and oxidative stress. And so when you see wrinkles, when you see skin damage, when you see poor quality skin, it's often a sign of inflammation and/or oxidative stress.

With the caveat that we all are meant to, as we get older, we're gonna have some wrinkles, we're gonna have some of that that's there, we're gonna have some of it, but we're talking about accelerated amounts that are there.

Yeah, I mean, it's interesting. Like, my main sun exposure has been on my face. Yeah. But if I look at, you know, my skin health and I, and I would guess, you know, I was getting body work done by somebody. Man, you're the body of a 30 year old. I mean, your skin health, elasticity, this, you know, because you can actually take your skin, you can pull it up and you see how long it takes to go down. And then it shouldn't be like, if you're, if you're old, it takes a long time. But, like, for me, it's pretty quick. and it can take up to a minute sometimes if you're old for the skin to go down. So you can actually have youthful skin by taking care of the inside. Now, if you get a lot of sun damage, that's going to cause UV radiation and that creates external inflammation and external oxidative stress, which is what happens. So I need to deal with that because I rented a convertible in LA and I got too much sun this week. But there's things, ways to fix that. But the beautiful thing about exercise is that it addresses all these hallmarks of aging. So whether it's DNA mutations, whether it's protein issues and protein folding issues, whether it's inflammation, or whether it's your metabolic health, we call it nutrient sensing, which is blood sugar issues, which are hugely related to your skin health, whether it's mitochondrial and energy production, all these things play a role in your skin health. the more you can do to actually halt or reverse these hallmarks of aging, which Edmond talked a lot about in my book, Young Forever, you actually can look younger and also be younger. A lot of people do a lot of stuff on the outside to look younger, but they don't deal with the easiest hack, which is getting younger from the inside out.

One of those that is also on that list is also the health of your fascia, the foundation of your fascia and your ability to move regularly, and then also get some deep tissue work and make sure you break up that fascial tissue. Chiropractors especially who are really aware of the role that fascia plays with your skin health will tell you that people can start looking younger just by getting regular body work done and improving the quality of their fascia. And actually, if you look at a lot of individuals as they age and there's lack of movement, there's a lot of sitting, and people start to hunch over, that's the pulling in of the fascial tissue that's starting to slowly, because there's no resistance counter to that component. So that's another area that movement significantly plays a role in how you look, your posture, your yoga, because you get.

The sauna and the exercise at the same time.

Totally, totally. Let's talk about a bonus one. This one is a good one to talk about. and that one is stress. Stress is one of those ones that can age you very rapidly. You know, some of my favorite presidential photos for any president, regardless of, you know, whatever side they're on, is like the photo of them when they first come into office and the photo four years later or even eight years later. And the level of stress they go through or anybody in any position, obviously, parents know a lot about this. So there's a certain level of, well actually let me just pass it over to you. How should we think about stress and the stress that we can't do a lot about and the stress that maybe we can mitigate a little bit with lifestyle practices?

Yeah, I mean stress affects us throughout every condition. I mean 95% of all diseases are either caused by or worsened by stress. So whether it's your skin or your heart, or cancer or your immune system, any aspect of your health is influenced by stress. And stress is defined as the perception of a real or imagined threat to your body or your ego. So it can be a physical stress or a mental stress. And often we live in a world that triggers a lot of mental stress. Most of us have enough to eat, most of us have a place to sleep, most of us have clothes to wear. But it's these psychological stresses that trigger a physiologic response that's the same as a tiger chasing you. And when you get that response, it's meant to be a quick short burst and run away from the tiger and then stop. But in our society, the stress just keeps going. There's a beautiful book written by Robert Sapolsky, a neuroscientist from Stanford, one of the most brilliant guys I've ever met who basically studied the stress response in baboons. He was like the Jane Goodall of baboons. And he wrote a book called why Zebras Don't Get Ulcers, which is based on the idea that the zebras are all eating their grass and grazing, having a good time, and the lion comes and starts chasing them. They all run like crazy. he catches one of them and then they all go back to eating the grass with the lion standing there eating their friend. And then they just like have an accelerated quick stress response and then it's off. In our society we keep having chronic stress. And so a lot of the hacks that I think, and we'll talk about this, a lot of the hacks that we can do are ways to reset our physiological state. We talked about saunas. saunas and cold plunges. That is a massive reset for your autonomic nervous system that can discharge the stress. Exercise. I mean, you're supposed to run from the tiger. So when you, your, your body is producing all these molecules that are getting you ready to run like cortisol. Cortisol is a stress hormone. So it makes your blood clot faster. It's good if you're running from a tiger, but not if you don't want to get a heart attack or a stroke. It causes you to have high glucose levels. which is great because you want a lot of sugar to fuel your muscles so you can run as fast as you can. But you don't want that prolonged high glucose because that leads to diabetes and more inflammation. It causes adrenaline to flood through your body, which causes all kinds of downstream consequences in terms of your heart and palpitations and blood pressure, anxiety. It all makes you want to eat more. It makes you probably choose the wrong foods because stress makes you crave carbohydrates. like sugar and starch. So this chronic stress response leads to all these secondary downstream effects that are harmful. And cortisol itself is something that increases as we age and growth hormone goes down. Growth hormone is a repair of hormone. Cortisol is, you know, stress hormone. It's not that it's good or bad, it's that when it's prolonged in its elevation, it drives all these downstream pathologies. So it makes your skin really damaged. if you ever see someone on cortisol, their skin is like thin as paper, you know, and they get fluid retention and they get inflammation, puffiness. So it's really important to understand that while stress is inevitable, our response to stress determines how that stress affects us. So that's why every day I meditate, I get enough sleep, I exercise, I do hot and cold, I eat foods that are not stressing my body because by the way, and this was shocking to me when I learned it. Even if you're like a Zen monk and you eat sugar, your cortisol goes through the roof. Your adrenaline goes through the roof. So you could be the calmest person in the world and an enlightened master, maybe they can transmute this, I don't know, but if they eat a ton of sugar and starch, their body's response to it is danger. Dr. David Ludwig did this study. It was fascinating to me where he took young boys who were overweight and said, Look, I'm gonna give you three breakfasts. Eggs, steel-cut oats, or a regular oatmeal. And they were all identical calories. Identical calories. And then he followed their blood levels. He had a catheter and he drew their blood like every hour. And then he said, Whatever you wanna eat, just push the button, bring your food. And so the group that ate the oatmeal, which we think is a health food, and I'm not talking about donuts or pancakes or French toast or frappuccino, cappuccino lattes or whatever the heck you're eating for breakfast. Those are worse. But the oatmeal caused these kids not only to crave more food, they ate 81% more calories over the course of the day because they were hungrier because of the biological effects of eating the oatmeal, increasing their cortisol, increasing insulin. They literally had a stress response in their bodies. Their cortisol went up, their adrenaline went up, their blood sugar went up, their insulin went up, their cholesterol went up. danger. Danger will rob us in when they ate the oatmeal. And so over time, that just creates a degradation in your biology. Your collagen breaks down, your skin breaks down, your, your, you get in extreme cases, you get increased acne and all kinds of other stuff. So it's, it's a real, it's a real problem.

All right, mark, I have a list of a few topics where people want to know. Is it hyped? Is it underrated, overrated, or appropriately rated when it comes to, like, aging and our appearance and other things like that. Supplemental collagen, what do you think about that? Is it worth it? And is it something that you think people could be including in their coffee or smoothie or taking in water?

Well, it certainly works when you inject it. I think, you know, it certainly is a source of amino acids and protein. And your skin structure and collagen is made of protein. you need to have the raw materials. And if you're protein deficient, your skin breaks down. The quality isn't as good, the glow isn't there. So you need aqua protein. And I think you can get it from many sources, including collagen. I'm not sure if it completely meets the hype that it has, but I think if people want to use it, it's fine.

Talk about hydration. People are really wondering at what level does, you know, a lot of people, I think the context of sort of this note here is that a lot of people don't know that they're dehydrated and they don't drink enough water throughout the day and they over drink caffeinated beverages or sugary beverages or sugary beverages. What does that do to the quality of your skin and how your appearances look on the outside? Well, we're 70% water.

And if you see someone who's dehydrated, I mean, you look, you know, clinically in medical school, we're trained to see, okay, when somebody dehydrated, they have these signs. their mouth is dry, their skin is more sunken, they actually, we do this in babies, we can pull their skin up and if it doesn't sink down, it means they're dehydrated. So your skin really reflects your state of hydration. Most people need to drink at least half their weight in pounds, in ounces of fluids. In other words, if you're 200 pounds, you drink 100 ounces a day. If you're 100 pounds, you drink 50 ounces a day, which isn't really that much. I mean, it's like 50 ounces is less than two liters, right? If you're small. And if you're bigger, you need three liters, four liters. I mean, you can overhydrate, which is important because especially now people are having reverse osmosis filters and they're drinking demineralized water. You need to make sure you have adequate electrolytes. So I always add electrolytes to my water because it helps create intracellular hydration. what happens is if you get too much water, and this is what happens with marathon runners who die because they essentially will be drinking a lot of water without electrolytes and they dilute their blood. You literally, all your components of your blood become diluted and so you get low sodium, you get something called hyponatremia, and that causes seizures and comas and death. So you want to make sure if you're drinking a lot of water that you're actually boosting it with electrolytes and minerals.

Yeah, another small version of that, people will always tell you that that are in the know, like our TB-12 coaches who we train with, shout out to John, if you drink water and you are cramping a lot from that water, that's also a sign that you may not be appropriately having the right amount of electrolytes in there. Brand that I like, no affiliation, no partnership, whatever, but I like Mountain Valley, we have it here. They have naturally occurring electrolytes in there. But do you add electrolytes? And what do you want people to know about a lot of the common.

Electrolytes that are out on the market? Okay, well I've tried all of them, or not all of them, but most of them. Most electrolytes either have sugar sweetened, or they're stevia sweetened, or they have other kinds of sugar alcohols, they have strong flavors, I. And the one I like, I found it's super simple. It has a little lemony flavor. There's no sweeteners to it. It's called light show. I don't have any affiliation with it. It's L-Y-T-E show. S-H-O-W. And it comes in capsules. It comes in also liquid. So I like the liquid. I just squirt it in. I do it every morning. I drink two glass of water when I wake up. I squirt and electrolyze. It's a great way to start the day. So you gotta get 16 ounces. Boom. Some people say you should drink 32 ounces before you. do anything else and I probably should do that. But it really is important to flush your system and I think a lot of people's fatigue and many health issues are due to sort of like low grade dehydraTion that people have and suffer from and aren't really thinking about it. So, and I encourage people skip plastic bottles because it's phthalates and BPA and often in those and it's just bad for the environment. You know, get metal bottles. Now, this is great that Mountain Valley has these metal bottles. I actually bought a Hydro Flask, which is a 32-ounce container. It's really nice. You can drink from it. I throw my electrolytes in there.

I keep it with me all day. It's great. There's another one. I just want to mention it because you've recommended in Mark's Picks before and a few other places.

It's called Elite by BodyBio. Do you still recommend that? Yeah, Elite is great. Elite is great. It's not for everybody because it's just really strong.

It's like salty.

So it's a taste then. So, yeah, so light show has some, like, lemony flavor that makes it. But you can. But see, with, with, with Eli, you could actually just squeeze lemon into it. Sure. I like it. I use it a lot. And it's like, it's one of the most amazing things, particularly when you're doing sports or athletics and you do it. If you take too much electrolytes, you'll cause loose stools and you'll be pooping, which I once filled up my, you know, 70 ounce. camel back when I was on a long bike ride in Maui and I put a ton of electrolytes in there. I was like, oh boy, this is another idea of exercise and detox here.

So I said we're going to come back to food. There's a few foods and nutrients that you want to give a little special love and attention to. So I'm going to pass over to you to jump into some of this. Yes.

So before we get into what to eat, I want to just mention what not to eat if you want nice skin. We talked about the oils and that's important because you want to have the right oils and most of us need oil change. We need avocado oil, omega-3 oils, olive oil. Those should be your staples and skip all the other oils, all the processed oils, trans fat and so forth. Animal saturated fat is fine if it's from a regeneratively raised cow, it's different. But mostly those are the fats. But the reality is that most people's skin looks terrible because the amount of processed food and refined carbohydrates and sugar. So not only sugar and carbohydrates, one of the number one source of acne, but it also drives inflammation and oxidative stress, which accelerate aging. There was a wonderful book by Nicholas Perricone called the Wrinkle Cure that I read years ago, which talked about the power of food to actually improve the quality of your skin. And he talks about upregulating obviously your omega-3s by eating wild salmon or wild fish like sardines, organ meats obviously, but also cutting out all the processed food, sugar, and starch, which is just the basic Pegan diet. And in addition, there's some really important nutrients that are important for skin. It's like vitamin A and vitamin C, vitamin E antioxidants help protect your skin, for example beta-carotene or the carotenoids which from all the orange, yellow, vegetables, sweet potatoes, avocados, they actually have UV protection. so when you, when you, when you look at some of the data, it's really interesting. If you take people who are sun exposed, if they eat these foods or if they take antioxidants, their skin doesn't get as damaged because there's antioxidant protection in the skin. There's this really cool machine that I saw years ago. It's a spectrophotometer. You basically put it on your skin and you get a score of your antioxidant score because it shines a light through and it can actually detect the level of antioxidants or carotenoids in your skin. And so, I mean, you can also get a fake tan by eating a lot of carrots. I did that once.

I was like on a carrot juice.

Kick like 30 years ago. It's a really bad idea. And I was like, wow, why am I so orange?

That happened to Steve Jobs.

I'm like, so orange. I'm like, I look like Donald Trump. Orange. But it's important to eat that. And also biotin, which is really important. And that's found in more in organ meats and other things. Biotin is a very important B7, or biotin, your gut bacteria make it very important for your hair, skin and nails. So making sure having adequate foods with these and even taking supplements can really be really helpful.

You know, a few years ago I came across this book called Faceercise. I don't know if you've heard of this, but they're basically these facial movements that you can do and they like strength and it's like lifting weights for your face, but you just need to do certain movements. Oh, my God, that's a stretch. It's a way to like stretch your neck skin out and like you have to do all these things. And I was thinking, you know, for a while I was like really curious about it. and I would do it. And I actually saw interesting results. Like your face looks more defined and the muscles look more defined. And I was chatting about it with a friend. I was like, you know what? I think if you just live an active life, you have a lot of friends, you laugh a lot. You laugh a lot, you hang out with people that make you laugh, you cry a lot, right? You just like whatever the full range of emotions are. And also I think working out, you know, the beautiful thing about working out is that you make all sorts of weird face contortions. You know, if you're doing a deadlift or you're pushing this down. I'm this tongue out guy. you're the tongue out guy. I've seen that. So I think that's another way.

To.

Incorporate it in without having to do. I mean, it's a lot of work to do those.

You remind me, my mother had this thing when we were growing up, I think it was called a dynatone, and it basically had these two electrodes. It was like, it looked like a. It looked like a taser, basically. And. And she would put on her face, make her face like this, and they're all their muscles contract in her neck, and she's like, put on. I was like, wow, that is a weird thing. I used to try to sneak in and try it. It's a kind of a facial, like a stimulation. Electrical stimulation machine. Yeah.

That's funny. That's funny. All right, Mark, this is the part of the podcast where we go into some community questions from folks on the topic of aging. I know you're not a dermatologist, but everybody always wants to know, what are your thoughts on Botox? Or are there resources that are out there that you could refer people to when it comes to, well, let's start off with Botox first, right? People want to know. There's a lot of people that eat really healthy, live really active lives, other things like that, and then they feel like, well, I'm in a career or a place or whatever that I want to do a little bit of Botox. I like the way that it looks for my skin. Are you worried about it? Are you neutral about it?

Are you cautious about it? I'm not so worried about Botox. I think it's a short acting compound that causes muscle paralysis that makes it look like you don't have wrinkles. And I think that's fine if people want to do it for cosmetic reasons. I think, I met this woman once who she never went anywhere without an umbrella. I'm like, what's up with the umbrella? She's like, son. And she literally had an umbrella wherever she went. It never went out.

Out without her umbrella.

And her skin, 50 years old, looked like she was 20. Skin is highly damaged by the sun. And my skin clearly has been damaged by the sun because I like to be outside a lot and I don't always put sunblock on or I should, but I forget sometimes. So, I think that there's a really.

Important.

Way to protect yourself from sun damage by which leads to the need for all these by wearing sunblock and the right kinds of sunblock. I'd encourage people to go to ewg.org, the Environmental Working Group, where they have a database called Skin Deep. And, it's a beautiful way to look up different products for your skin, including sunblocks to find out which have the least toxins. Because I had a woman who was always using sunblock and she had high levels of parabens in her body and it was kind of toxic. And, so you want to be careful with that. Also, there's a lot of techniques that actually help rejuvenate the skin. skin that are available to people, including lasers and microdermabrasion and fillers and a lot of stuff people are doing. And I don't have any judgment about it. I think it's fine. I think. I think where I, where I have a problem with it is when people focus on that and don't also focus on beauty from the inside out. Right. Because that friend of yours, again, no.

Judgment on the situation or whatever, she was protecting her, her skin from the sun. But if you don't have regular sun exposure, there's a whole other thing, whole host of other things you're missing.

Vitamin E deficiency.

And your circadian rhythm is not synced with a day. I have a friend who is an esthetician here in LA and everywhere she goes, she wears a sun mask and then carries an umbrella and other stuff. And I, again, people can do anything that they want to do, but we obsess over one thing and we might be losing out on other stuff. Not to mention the joy if you're constantly worried about sun and you think the sun is doing something to you all the time. Yeah, it's a problem. Instead of just being smart, right?

Yeah, and I had a lot of sun damage on my skin from just years of being in the sun. And I actually went to dermatologist, they can actually look at this skin through these incredible fluorescent imaging things. And you see all these precancerous spots. So, I had a treatment that kind of cleared all that stuff. And all these spots, literally all these precancerous lesions fell off.

There's also- what was that treatment called?

Just single laser treatments, fractal lasers. There's also creams like 5 FU that dermatologists used to deal with, you know, kind of cleaning up all the surface damage. And there's ways to build collagen in the skin naturally. So there's a lot of really exciting dermatologic advances in looking younger. And we just had Tony Robbins on our podcast and Peter D'Adamo is talking about their book, Life Force. And there's a whole section in there on what's emerging in the world of skin rejuvenation and dermatology. so it's kind of exciting. I mean, the future looks even more wild. I mean, we're, or we're going to be able to actually reprogram our cells back to younger cells through really cool technologies that seem sci-fi but I think are around the corner, such as, for example, two process of gene editing, inserting combination of genes that have been discovered called the Yamanaka factors that can be switched on to reprogram your cells to reverse back to their embryonic state. We call those inducible pluripotent stem cells. And those undefined stem cells could then re-differentiate into whatever tissue organ. So, skin rejuvenation, there's so much fun stuff coming down the road. So, not only will you be able to live to be 120, but you'll be able to look maybe 60 at 120.

Yeah.

And, you know, one thing that we'll share in here, and I'm sure you'll talk about in your conclusion, is that We want people to look however they.

Want to look, right?

At the end of the day, be happy with yourself and there's a sense of just accepting yourself and however you want to show up. So this is really not a conversation about looks. It's really that the way, the byproduct of feeling good is that also the likelihood is you tend to look good as well too, if you want to do those things comparatively to what the baseline would be if you're eating a standard process diet that's out there. So number one, we want people to feel great because when you feel great, you can give love and attention to all the things in life that truly matter. And that's way more than just your looks. It's being there for your grandkids, it's being able to show up for your partner, it's being able to give back to the world, it's being able to make a difference in your spiritual or church community that's out there, it's being able to give back or build a business or whatever it might be, make a difference. So that's why we wanna feel good. And as a byproduct of that, because we know we'll catch some people's attention who are focused on wanting to look better, nothing wrong with that. The best way to do that is from the inside out. All right, Mark, we have a few more questions. This is from the Dr. Hyman Plus community. One of the first questions we have is from Charlotte who asks, what kind of sauna does Dr. Hyman use, infrared or regular? And what would you recommend to the population that's out there?

I'll take whatever I can get. Steam sauna, infrared sauna. I think there's varying, you know, arguments about which is better, worse. I think they all work. I think the infrared saunas, you can stay longer. There's a little more penetration in your skin, a little more detox benefits. It's less sort of hot and intolerable, which some people don't like actual saunas. For me, I like to go to the Russian room at the 10th Street Bathhouse in Lower East side, New York, where my great grandfather used to go, which is like this Stone room, literally, it's made of stone and there's a giant oven in the room which is turned at full blast. You're literally sitting in a baking oven. And I don't know how much it is, but it's really hot. It's super hot. I took you there, didn't I? Yeah, we went there. We went there.

But I had been there one time before previously. That place is like an institution. It's been there forever. I'm a little worried about mold though inside there.

I don't know.

It's a little gross.

It's a little intense, but it's a great place. I don't think the mole can live in the 180 degree of that.

Yeah, I'm probably thinking about it too much. Okay, next question also from Charlotte is, what is the ideal Omega 3 to 6 ratio? Do you know that offhand?

Yes, I mean, I think that there's conversation about it. I think anywhere from 4 to 1 and down is fine. So, 4 to 1 Omega 6 to 3, 3 to 1, 2 to 1, 1 to 1. And, there are tests that we use to look at this. part of the diagnostics I do as a functional medicine doctor, we do the OmegaCheck, which is one, we use the ion panel, another from Genova Diagnostics. So we can actually tell what the composition of the fats that people are made of. And it's fascinating to see. It's like, wow, you really need an oil change or, oh no, you're good. Or you're deficient in this or you have too much of that. And it's really helped people. I go, and you can really tell what people are eating from. I mean, it's so amazing. People are like, how do you know I'm eating that? I'm like, I can see. I had a friend the other day come to me with his neurotransmitter test and he was freaking out because he had this really high level of one analyte, which was phenylethylamine, which sounds like something bad or I don't know what. And it was off the chart. He's like, what is this? Should I be worried? I'm like, do you eat a lot of chocolate? And he's like, yeah, every day. And I'm like, well, that's what it is. You're peeing out the phenylethylamine, which is the love bomb chemical in chocolate.

And it's not a problem, but just.

That'S where you're getting it from.

That's funny. One of the first tests that I did when I discovered the world of functional medicine, it's actually a test that people can order at home and it's the OmegaQuant test. It's a little prick test. You could do it at home. You don't need a practitioner to order it. Again, no affiliation with the company. And it's 99 bucks and you get your full Omega 3 to 6 ratio and a whole bunch of other details on the quality of your fats, including they have one marker inside of there that helps you understand the level of trans fats that you're consuming.

Yeah, that's the other thing. You can tell people eating junk food. I'm like, ah, you're eating junk food, aren't you? They're like, how do you know? I'm like, well, it does it on your lab test. You've got high levels of hydrogenated or.

Trans fats, which are highly dangerous and really can be deadly. Yeah, we'll have a link to that in the show notes. Again, cool test. I love anytime people can order tests and get it from home. That one's relatively inexpensive as Tesco, but still, About 100 bucks. Okay, great. Next question. Anine asks, How do you ensure that all those good fats you're eating are absorbed well by your body? So let's even take a step back and say, Are there things that can be happening in our body that prevent us from absorbing good quality fats that we're having in our diet?

Sure. I mean, Drew, you know, functional medicine, I do stool testing all the time and I can see if there's fat malabsorption. If it is a pancreatic problem, enzyme problem, and the truth is, though, most people do a pretty good job of absorbing fats. There's a system in the gut that breaks down the fats or absorbed through the lymphatic system, except for MCTO, which is a little bit different. And, and they're then metabolized and put into the circulation. So I, I think for most people, it's not an issue. But, but there are certain people who have enzymatic issues with their pancreas, whether it's, you know, they've had pancreatitis or they have cystic fibrosis or they have low-grade pancreatic insufficiency. As we get older, we have more pancreatic insufficiency. So sometimes taking digestive enzymes can be very, very helpful. And so I recommend people take digestive enzymes if they're concerned about that.

That's great. Fantastic. I also know that some people don't always do great with concentrated dosages of single fats, especially if you have a history of leaky gut or other stuff. you can have a reaction to if you use a lot of coconut oil or cook with coconut oil or you're using a lot of saturated fats like butter and things like that. I know that I can do generally okay with coconut but if I have coconut oil then I find that it's a little bit problematic. I actually noticed a few years ago that a really strong redness that I was having on my face and inflammation that was on my skin and I had a history of having acne, was directly connected to a high dose, anytime I would use coconut oil or MCT oil, I'd get a little bit of a reaction. And I found out that it was an endotoxemia situation. Again, that's more of a unique situation, but sometimes go to whole food type fats that you have. Yeah, that's interesting. And dial back a little bit from the concentrated sources of fats if you seem to be not doing well with them.

Yeah, I agree. there's some interesting studies. We just mentioned a word I think it's important to talk about, which is this idea of metabolic endotoxemia. What that means is that when you eat certain foods, it drives the production of certain bacteria that then produce these secondary compounds, these endotoxins called lipopolysaccharides, which are basically poisons. It's a bacteria's way of doing bad stuff. and those are absorbed in the body. And then the immune system says, Ooh, that's bad. And it starts triggering inflammation. That inflammation starts triggering insulin resistance and diabetes and fluid retention. Because by the way, inflammation drives fluid retention. So when you see people go through a functional medicine program or eat the Pegan diet, they'll just look younger because they'll get rid of all the inflammation in their body. The fluid just drops out of their tissues and they have kind of a more normal looking appearance. I had one patient who was, she wasn't a remainer or anything, but she had long, long-standing inflammatory issues. And she said, Dr. Hyman, Dr. Hyman, there's something wrong. I'm like, what? I said, I can't, I can see all my knuckles. And I never saw my knuckles before because her hands were like sausages because of all the inflammation. And when the inflammation went down, she could actually see her, her knuckles.

She thought there was something wrong. I'm like, no, no, that's okay. so here's another question from the community, and it's a little unrelated, but a little related to the longevity topic. So the community member says, I've heard metformin mentioned as possibly having longevity effects. I was on this for almost 15 years, and I was very happy to get off of it when I lost 65 pounds following the Pegan diet. Do I benefit, do the benefits outweigh the negatives with metformin? I've listened to so much functional medicine that someone, even a non-diabetic, taking metformin confuses me.

Yes, I agree. It still confuses people and it even confuses me, to be honest with you. And, I've been digging deep into this. So, what you're talking about is a drug that's been available from a Viacell plant, I think, from France that has been used for a long time as a foundational treatment for type 2 diabetes because it helps with insulin sensitivity. this particular drug is generally very safe. It can cause problems, it can cause digestive issues, it can maybe have adverse effects on the mitochondria over time. But there's some really interesting emerging research around its effect on longevity because one of the key pathways, and I write about this in my book, Young Forever, which is coming out in February 2023, is that it helps to regulate the nutrient sensing pathways that control aging around longevity like AMPK, which is a particular nutrient sensing pathway. And so if you're eating a lot of sugar and starch and having a lot of insulin resistance, it actually can be very effective in helping to activate a number of pathways. And there seem to be other secondary effects that we're just learning about that may be beneficial for longevity. So am I taking it? No. Am I learning more and thinking I might take it? Maybe. So stay tuned. I just need to do more work on it because I'm not convinced because I, and here's why I'm not convinced. I think that there are so many better ways to access the same pathways and to regulate those nutrient sensing pathways. And the reason is there's a major study called the Diabetes Prevention Trial or DPP that was done many years ago where they did an experiment where they said, and these are people who are pre-diabetic they said, okay, if we give people a pre-diabetic Metformin, nothing or lifestyle change, what happens? And they found a dramatic improvement through the lifestyle change. The lifestyle change worked 58% better than the Metformin, which worked better than doing nothing. But if you're changing your lifestyle, works 60% better than Metformin, why take Metformin? That's my view.

Super fascinating, Mark. All right, we're wrapping up. Let's do a little bit of a recap on some of the top things that you think can play a significant role when it comes to the secrets to looking younger, which is really beauty from the inside out. So do a little recap on some of the stuff that we mentioned and some of the take homes that people can implement really starting today.

Absolutely. I mean, I think the most important thing to do is to clean up your diet. It's just that is number one, two, and three. So Pegan diet is great. You can even go further than that and eliminate all dairy, which can be inflammatory, all gluten, all sugar, alcohol, all those things can be pretty damaging in terms of your appearance of skin. But it depends on the person. So if you really want to do a reset and see how you feel, that's a good way to do it. friend who I saw the other night who's 65 and was complaining about getting older and aches and pains and her skin and this and the fluid. And I'm like, she's like, can I come see you? I said, save your money. Don't pay me anything. Do this 10-day detox diet, the reset we talked about, but do it for 21 days. And she says, and she came over, she says, I'm so mad at you. And I'm like, what? And she starts hitting me and I'm like, what? What? She says, I feel so great. But I'm not having alcohol. I'm not having this. I'm like, okay, fine. But, you know, you're feeling so good and you look so good because you change your diet. That's the first thing. Get rid of inflammatory foods. Add in all the anti-inflammatory foods we talked about. Things like, you know, guacamole, chopped liver and sweet potato is a good skin meal with a little bit of maybe sardines on the side. How about that? I would like that meal. Actually, that sounds really good to me. Maybe not everybody. The second is move, move, move your body because it activates all the longevity pathways, longevity switches, it shuts down all the hallmarks of aging, super powerful, hot and cold therapies, really easy as we talked about can be implanted, don't really cost much. I mean, if you want to buy a sauna and so forth, it can be expensive, but there are ways to do it without. And then make sure you're taking the right nutrients. I think fish oil, a good multivitamin, making sure vitamin A and zinc and vitamin C and vitamin and E. And then I think for, for the other pieces, which are the sort of outside in, I think, you know, whatever feels good to you. I think people, someone, people want to get really aggressive and do a lot of laser treatments and Botox and fillers and collagen. I have no judgment about that. But I, I think that, that, you know, often the results are so powerful from the inside out that people often won't need that. Yeah.

Or they'll need less of it.

Or less of it. Yeah.

Those things influence your brain and you also start to feel more content with yourself. So you're like, I'm not as worried about that wrinkle or that thing or whatever, because I feel good. And again, you want to do any treatments you want to do, great. There's no judgment at all. Let's try the lifestyle interventions first so we can actually feel better, not just look better. Fantastic.

Hey YouTube, if you like this video.

You'Re gonna love the next one.

Whether you have acne or eczema or psoriasis, or rosacea or any one of the myriad skin conditions that we get, most of them have their root cause inside, not on the topical level.

Exactly.

And often it's the gut.

Yeah, absolutely.

So you mentioned a little bit earlier leaky gut. So take us through from a functional medicine perspective, our thinking about the root causes. What are the things that you think about when someone comes in your office.

And their face is all red and.

They got all this acne on there and they've got these telangiectasia, these little red lines everywhere and you can see the blood vessels dilated, and they're kind of looking like Santa Claus.

Yeah, exactly. And they also get photosensitivity too, which is the other thing. And the interesting thing is, they can't.

Go in the sun without getting it worse.

And that also ties in with these antimicrobial peptides because it's thought, it's theorized that the Celts, the ones who live in the higher northern latitudes, they don't get as much sun as we do. so it's thought that from an evolutionary standpoint that they benefit by having this. They have a more robust immune system when there's not enough sunshine. And sunshine will actually activate this innate immune system and that's why sun exposure oftentimes makes it worse because they produce more of these antimicrobial peptides and then those antimicrobial peptides have to get processed and in the process of breaking them apart, the immune system then starts responding to it. So that's why there's sort of a.

Photosensitivity aspect to it. And what are the other sort of things you think about when someone comes.

To your office with rosacea? Well, one of the things I oftentimes look at is their vitamin D levels. Vitamin D is part of the immune system and it's tied in with intimately with the antimicrobial peptides system in the body. So oftentimes patients who have this have low vitamin D levels. We'll look at the microbiome testing to see if there's any evidence of dysbiosis, bacterial overgrowth testing, the SIBO testing, checking for hydrogen and methane. I mean, probably the majority of patients who I see of rosacea have problems with bacterial overgrowth. Other thing is low stomach acid, which also promotes and contributes to bacterial overgrowth. So checking for the patients, sometimes these patients are also on PPIs. Acid blocking medications, absolutely. Because we have acid in our stomach to help us to digest food, it's also there to decrease the amount of bacteria higher up in the colon. So it's good to have stomach acid.

Yeah, because if you don't have stomach acid, then the pH of your small intestine changes, becomes more alkaline, and then bugs grow in there that wouldn't necessarily grow. And that's when you get this overgrowth of bad bugs in there. And it can be what we call SIBO, which is small intestinal bacterial overgrowth, where bad bugs migrate up from the lower intestine into the small intestine. And then when you eat food, you get bloating, distension, It causes leaky gut. You end up causing damage to the lining of the gut and food particles and bacterial toxins leak in and create inflammation throughout the body and on the skin. So, you know, leaky gut can cause hundreds of different manifestations, one of which is rosacea.

Yeah.

And unless you think about that and know how to treat it, you may not be able to be successful with it. There's also another condition that I've seen.

Todd, in a lot of my patients called SIFO. SIFO.

Small intestinal fungal. Small intestinal fungal overgrowth.

Yeah.

And a lot of people talk about it as candida, but there's many, many species of yeast and fungus. And so what I found often is that treating the gut through addressing the bacterial overgrowth, the yeast overgrowth, healing leaky gut, dealing with the food sensitivities makes a profound impact. And a lot of times it is food sensitivities that can trigger. I mean, for example, gluten we've talked about on the show, that is one of the biggest drivers of leaky gut. And even if you are not celiac, and even if you don't think you have any symptoms, or don't notice any symptoms when you eat gluten. Dr. Alessio Fasano, who's the world's expert at Harvard on gluten, he said everybody who eats gluten creates some level of leaky gut.

Now, most people kind of handle it.

Right, transient leaky gut, exactly.

So, I don't know. It's probably not a good idea to eat that much gluten because of the potential to create leaky gut and how that is linked to so many chronic diseases, including weight gain, diabetes, cancer, heart disease, Alzheimer's, autoimmune diseases, allergies, I mean, you usually name it, depression, all this stuff is connected by, by leaky gut. So I really, I think, you know, getting a very different thinking about this is key. And you did, you talked about the stomach acid, you talked about the acid blockers, you talked about maybe other things that, that, you know, are relevant in the gut and fix certain infections like H. Pylori, which is a common bacteria that causes ulcers, also has been linked to H. Pylori. and food sensitivities.

So how do we approach these patients.

When they come in? What are the kinds of things that we would do from a diagnostic point of view that you wouldn't get when you went to the dermatologist?

Well, from a diagnostic standpoint, again, I would do testing for, you know, leaky gut, I would do intestinal permeability testing, checking for antibodies to zonulin with the Cyrex testing that we do, Cyrex Array number 3.

So that's basically, there's a test that we do at the center at the Ultra Wellness Center here in Lenox, Massachusetts, where we're recording live, is Cyrex Testing. It's a lab that looks at antibodies that you produce against these proteins that are in your gut that come from gluten or even from bacteria. And so if you're creating a lot of antibodies to these proteins, it's clear that they're getting across the lining of your gut, leaking into your bloodstream and causing an immune response which is not only local but systemic.

Right, and there are other ways you can actually measure zonulin in the blood and you can measure it also in the stool. And that's only like a snapshot in time. So you can develop leaky gut for, you know, a couple hours or a day or so, but if it stops then you're also fine. The antibodies against zonulin is the one that tells you that there's this chronic leaky gut, which is really more valuable. Because if I gave you a shot of tequila then, you know, an hour.

Later measure your zonulin, it's gonna go up. Okay, where's the tequila at?

Yeah, sounds good. Right. that's why I think that the testing for the antibodies against zonulin is even more valuable in these patients with chronic conditions.

And what other kinds of tests besides the zonulin and the lipopolysaccharide test that we do to look at the antibodies against these proteins in the gut that come from a leaky gut?

We'll do the small intestinal bacterial overgrowth where we measure the production of fermentation products. So hydrogen and methane are gases that are normally produced in the body. when people have small intestine bacterial overgrowth, those will be produced at higher levels. So we can check that. And over time, or I think the test that we do is a three-hour test. So you measure Baseline hydrogen methane, check it at intervals of about every half hour, and you do that over a three-hour time period. That can tell you definitively, do you or do you not have bacterial overgrowth? And how bad is it? And it's a predominantly hydrogen or is it methane?

So essentially, essentially what you're saying is that and that when we eat foods, humans don't produce gas. It's the bacteria that are fermenting the foods we eat that produce the gas. So if you blow it or distend it or you're passing gas, it's not you. You can blame it on the bugs. But the problem is that we don't.

Know how to regulate the bugs and.

Get a healthier ecosystem. And that is what most physicians never were trained to do. And it's the foundation of functional medicine. It's the foundation of our practice here at the UltraWellness Center. where we really dig into these issues and we look at bacterial overgrowth, we look at fungal overgrowth, we look at a leaky gut, we look at food sensitivities, we'll do other testing, look at whether you're reacting to gluten or dairy or eggs or other foods.

And it's really helpful in drilling down.

On what's really going on with people. Absolutely. And that, you know, we're talking basically producing gases. That's basically a fermentation process. And normally fermentation happens lower in the colon. That's in the, in the colonic area. The ant, when it was more of an, an anaerobic environment or a lack of oxygen. And that's normal for that to be happening. But when that process is taking place higher up in a different neighborhood, it's not a good thing.

Yeah.

And, and, I mean, you want your upper intestine to be sterile and.

Or mostly sterile. Mostly sterile.

And when, and all that bacteria migrates up there, it's just a bad situation. And when we take acid blockers, when we, you know, are low in magnesium, which half us are, when we're under stress and our gut motility is slow, when we. you know, taking lots of antibiotics and it screws up our whole system in there. You know, all these are reasons why we get these bacterial overgrowth issues and they're super common and they're easy, relatively easy to treat with functional medicine. Now, the other thing we do is look at stool testing, right? So we look at not just the proteins from leaky gut or we look at the food sensitivities or bacterial overgrowth, gas production, but we actually look at the poop.

Yeah.

So what are we looking for in.

The poop that helps us figure out what's going on? well, there's a lot of things, you know, there's gold in there. It really is, it's- Golden NEM-DAR Hills. Golden NEM-DAR Hills, yeah. So a lot of information can be determined by doing microbial analysis. So you can look at the overall balance of bacteria. So there are, you know, everybody's got hundreds of different kinds of bacteria in the GI tract. And we can measure those using DNA PCR analysis. And we can do quantitative, we can measure how many there are of each different species. Look at ones that are normally found, look at ones that are found in the gut, but normally they wanna be at low levels. Look at bacteria that are associated with autoimmunity. So things like Citrobacter, Klebsiella, Salmonella, et cetera. We can look at now analyze for yeast overgrowth, various forms of yeast, and then also microbial markers of inflammation, things like Calprotectin, looking for fat, So you.

Can get a lot.

Exactly, enzyme function, butyrate, checking for butyrate.

Short chain fatty acids, indicators of healthy ecosystem. So, you know, Todd, what you're saying is that, you know, traditional sort of microbiome testing, they just look at the genetic material of the microbiome and they can't really test everything, although they can do some really extraordinary tests now. But there are kits out there where you can look at your microbiome, but it's far more than just what bugs you have in there. It's what they're doing. So we look at the, the result, the function on the ecosystem. We look, like you said, at the enzyme function, absorbing your food, is there inflammation? Are you having good bugs in there that are producing the super fuel for the gut, these short-chain fatty acids that are so important? Oh, huge. Do you have the right balance of gut? Are you missing some key bugs? You have overgrowth of bad bugs?

You have yeast, you have parasites. And it's such a much more comprehensive stool test that we do here at the Ultra Wellness Center. We were talking earlier about Delta sleep. And the interesting thing is that when you have good bugs in the digestive tract and you're eating in a fiber in your diet and you're producing higher levels of butyrate, that has an effect on the brain and also improves sleep.

That's amazing. So you have to get your poop together to sleep better? I got it, okay. That's a good strategy, better than taking Ambien. All right, so we also look at other things like omega-3 fats and other fats, 'cause a lot of inflammation comes from not having the right balance of fats in your body.

Yeah. And, and I think, you know, so.

So when you have a patient come in, what are the, what are the.

Steps you would take initially to, to.

Treat a patient with rosacea from a functional medicine perspective?

You know, again, taking the history is the big one. You know, I always will ask people what's your ethnic background? A lot of people say, you know, I'm white. No, it's like, you know, are you Irish, English, German, Jewish, Russian, whatever? Because the rosacea is typically found in, in light fair-skinned people. And from a genetic standpoint, they are the ones who are more likely to have that. It's just an interesting part to have in terms of the history. And then I'll just ask them, you know, what is it you're eating? Are you eating a standard American diet? How much alcohol are you drinking? How much stress do you have? Stress also- Caffeine. Caffeine can play a role. Those are all things which can sort of, you know, it's like adding gasoline to the fire because literally rosacea is the skin on fire in the facial area. but doing the testing for essential fatty acids, making sure that they have the right balance of the essential fats in their diet. A lot of people are, have too much Omega-6 which tends to be more pro-inflammatory yeah. Lack of the Omega-3s. One of the oils, I don't know if you've used it that I, that I found it very helpful with patients who have rosacea is borage oil and even criminals oil. Yeah, they tend to be very, they help to dampen down that inflammatory response.

And that's a very key Omega-6 that people don't think about much, but it's called gamma-linolenic acid, which is a very powerful anti-inflammatory it's not like the Omega-3s, but it's sort of like the Omega-3s, but on the Omega-6 side.

Exactly.

And it's something we really have a hard time getting in our diet. It's from like borage oil and, you.

Know, a few other things, but evening primrose oil.

So, yeah, that's very powerful.

I agree.

And I also think that, you know, when I see these patients, I also think about looking for other clues, like, do they have yeast issues? Have they been in lots of antibiotics? Are they on acid blockers, which caused yeast overgrowth. Do they have other fungal issues? They have dandruff, do they have anal itching, do they have thrush or white coating in their tongue? Do they have vaginal yeast infections? Do they have other skin markers of yeast like little tinea or other kinds of things? So you'll see often a pattern of other issues around fungal stuff. I'll check for H. Pylori, I'll check again all the tests we did talk about and see what's really going on.

And then from the treatment point of.

View, you start with an elimination diet with an anti-inflammatory diet, right?

Yeah, exactly, yeah. Putting patients on an anti-inflammatory elimination diet, 80% of the time, doesn't matter what they come in with, they'll actually get better. Getting them off of the pro-inflammatory foods and then putting in foods which are anti-inflammatory, cold water fish, sardines, wild salmon, the essential oils like evening primrose oil help to sort of dampen down that inflammatory response. Yeah, I agree.

I think, you know, we don't understand.

Most of us how powerful food is as medicine and how it can drive tremendous amounts of inflammation throughout the body. And, you know, obviously, if it's on your skin, it's visible, but there's also invisible inflammation that you're not seeing that's.

Driving all the chronic diseases. And is that, you actually just, you triggered a thought because there's actually a paper that says if you have rosacea, you have a higher instance of Alzheimer's disease. Oh wow. So it's not just a cosmetic issue, it's actually systemic.

You have a red face and a.

Red brain that's on fire. Exactly, yeah. I was sort of blown away by that. That's fascinating.

Yeah, especially in women.

It's actually more common in women.

So you advise people the obvious things, cut out the alcohol, the caffeine, stay away from the sun, stay away from spicy foods. We also tell them stay away from gluten, which triggers leaky gut, often dairy, you actually add in all the anti-inflammatory foods that are important, all the phytochemicals from plant foods and turmeric and ginger and garlic and rosemary and all these powerful foods that can really help to reduce inflammation. And then we often directly treat the issues that are going on. It could be leaky gut. So we give them a gut repair program. This could be fungal or bacterial overgrowth. So we'll take care of those with either herbs or antibiotics or antifungals. and you'll see these patients really dramatically improve when they change their diet and they resort their gut. And then sometimes we'll use, like, things like even primrose oil. I found that digestive enzymes and hydrochloric acid.

Absolutely. Often are really helpful, too. Yeah. I've been so. I've been surprised at how many people have a. What I would call a relative lack of hydrochloric acid in the stomach. I was adventuring to say that, you.

Know, the majority of people don't have too much acid. They have not enough acid in the stomach. yeah, well, that's interesting because the third leading category of drugs are the acid blockers, like prilosec and prevacid and Pepsi and Pepsi and all these other drugs, these.

Yeah.

Nexium, mass effects. I mean, they're just, like, out there everywhere, and now they're, now they're over the counter. And everybody. Yeah, exactly.

Yeah.

I mean, I, I just, I, we've talked about this before in the podcast, but when I was in medical school, the drug reps came in because it's drugs that just come out and they're like, listen, guys, these guys, these drugs work. They're, they're great. They will help you with ulcers if they're really bad. You don't want to keep anybody on.

It for more than six weeks.

Right, that's a huge.

It was a big red flag.

Stomach acid, it's really bad long term. These are the drug reps telling us this. And now it's like, people are on it for decades and it causes B12 deficiency, magnesium deficiency, zinc deficiency, osteoporosis, osteoporosis, pneumonia, bacterial overgrowth, irritable bowel syndrome. When you get rid of your heartburn, but you get all these other problems. Yeah, that's, that's true. And then it's one of those drugs that's so snappy. sneaky because it's addictive. Once you get on it, it's hard to get off it because it causes this rebound.

So.

Absolutely. When you suppress the stomach acid and you stop the drug, the acid production goes crazy. Exactly. Which makes you feel horrible. And then you go, I need the drug.

But you can actually taper it down and use other strategies to help people get off it. And you bring it. You bring up a really good point because a lot of the, the pharmaceutical medications, especially some of the psychotropic, so the antidepressants are like that. too. The PPIs on the antidepressants, when you try to get off of them, you get this rebound process. The body tries to get back into balance and it can be very difficult. So you've got to go low and slow when you're trying to taper off the PPIs or taper off antidepressant psychotropic meds.

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Turns out our gut microbiome is hugely important in regulating metabolism and weight. The next is inflammation, which can have many, many causes. So anything that causes inflammation will make you gain weight, even a virus or a toxin or mold, even if you are not eating a lot.