The Real Reasons We Have Trouble Sleeping

Guess what? Your brain takes out the garbage at night. So if you're not getting good deep restorative sleep, you can't clean the brain.

Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F, F-A-R-M-A-C-Y and welcome to this special episode called House Call. And it's about sleep today. And we are going to get deep into sleep, but we're not going to put you asleep, I hope. And I'm here with my good friend, colleague and Partner at the Ultra Wellness Center in Lenox, Massachusetts, Dr. Todd LePine, who I've known for decades. We worked together at Canyon Ranch over 25 years ago, and he's been involved with functional medicine longer than I have, which is a long time. I really respect him. He teaches all over the world, is one of the leading thought leaders in the space of functional medicine, and welcome to the Doctor's Pharmacy. Thank you, Mark. All right, so this house call today is about sleep, which is a big problem. I think we have an epidemic of sleep problems.

Yes, we do.

Tell us how prevalent is this and what's going on with our sleep?

It is. So you bring up a really good thing. So most people when I ask, one of the big questions I ask them is how do you feel? Where's your energy level on a scale of 1 to 10? And do you wake up refreshed? And a lot of people are not waking up refreshed. So I think what's happened is we're living...

I'm refreshed enough to have my coffee.

Yeah, exactly. And I'm actually gonna talk about coffee and how actually coffee works on interrupting that thing that triggers sleep, which I'll get to later.

Wait, wait, are you gonna take away my coffee time?

Yeah, no, no, I will not. I love my coffee. I had two cups this morning. It's a legal drug that got me through medical school and my medical training. But anyway, I think what we have in the modern society is a disruption of our sleep-wake cycle. So when you look, I always look.

At-- But it's prevalent, like 70% of Americans have sleep issues, right?

Absolutely, yeah. We have into our bodies our natural sleep-wake cycle and that natural sleep-wake cycle is part of how we are as animals. So when you look at most animals, you know, what happens at nighttime? The sun goes down, what do they do? They go to sleep. They're not on their iPads, they're not on their iPhones, they're not on their computer, they're not on their television. They don't have a light bulb.

And they're not right in the refrigerator, all right?

All of my cats run around at night looking for mice. If they're nocturnal, right? Yeah. So I think that, in my opinion, one of my experiences, artificial light at nighttime, I think is a big, is the sort of the elephant in the room. And for people that have had sleep problems, one of the easy things that you can do that can help to fix that is to have a blue blocking glasses at night.

Yeah, I actually have them.

I do too, absolutely. So when you look at the, you.

Look goofy, but you sleep good.

Right, exactly, yeah. And it's actually in the medical literature, and these LED lights, have a very high blue spectrum. And blue light is the type of thing that sort of wakes your body up and it suppresses melatonin. So melatonin, which we can measure, we can measure that easily in patients, is the hormone of darkness. So one of the times when I'm seeing patients, not only do I measure their sex hormones, their adrenal hormones, but I also measure their sleep hormone, which is their melatonin. At night, maybe. Yeah, at night. So you actually, you can check it in the morning, and you can also check metabolites of melatonin. and your melatonin levels tell you whether or not you're getting enough darkness. So you can take melatonin, and as you get older, our bodies produce less melatonin, but the thing that you can do to boost your own melatonin is not expose yourself to light at night.

Candles, back to candles.

Back to candles, yeah, exactly.

Blue blocker glasses?

Yeah, yeah, candles actually work quite well. Yeah, they do. But the LEDs on screens and all lights now, no more incandescent light bulbs.

So what about the, the sort of night sort of setting on the computer iPad. Is that just garbage?

It doesn't cut the mustard. It's not as good.

What if you wear the glasses when you use the screen?

Yeah, and you'll know they work because when you wear the real ones that really cut out 99.9% of the blue light, you can see.

I did the other night, I was tired, but I put my glass on and my blue light glasses I got from TrueDark and you go to truedark.com and you you put the glass on and I watched my movie on my computer in bed and I was like, normally I kind of mess with my sleep a little bit, but it was like fine. I had a great deep sleep. I was like, wow, this is really amazing.

Yeah, I mean whatever you're gonna do with computer, whatever, it's not gonna look normal, but you will sleep a lot better. And I do that myself. And I actually, this is where it really hit me about the effect of light. I was in New York City one weekend. and I was giving a lecture. And it was a Friday night and I was lecturing the next day. And I'm walking down, you know, just, what do you do in New York? You walk down Broadway. So I'm walking down Broadway. It was about 10 o'clock at night. I did it for a couple hours. It was like 11, 12 o'clock. Oh, yeah. And the lights on Broadway? I could not sleep that night. And that's where it really hit me. I was like, oh my God, this is, I mean, this was obviously real, real bright LED lights. But it was phenomenal. I just could not fall asleep. Wow.

I could not stay asleep.

That's incredible. And that sort of got me down.

That path of really understanding. Light.

So light is a big problem.

Light pollution. Light pollution. Exactly. I mean, there was a book I read years ago called Lights Out, which describes the advent of chronic disease and obesity with the light bulb. Yes. And how that affects our sleep wake cycles, how it affects our circadian rhythms, how it affects our hormones, how it affects our metabolism, which is something we really don't think about. Exactly.

Especially in traditional medicine, we never learned about light. Exactly.

But now, you know, there's...

I mean... And one of the best things that you can do, and I try to do this as often as I can, is early in the morning, exposing yourself to light. So darkness tells you to go to sleep. Light tells your body to wake up. And exposing your eyes without... actually even without glasses to the sun. I'm really a sun worshipper now. I'm sort of, you know, sun gazing. It is very, very powerful for sleep.

You're blind, but you sleep fine. Yeah, right.

Yeah, you're blind, but you sleep fine, exactly. But exposure to light shortly after you get up is one of the things that helps to synchronize your circadian rhythm. It's true.

Every morning, my wife and I, we get up and we take the cats for a walk around the yard. Yes, our cats go for a walk. They're well-trained Burmese cats. And we literally walk around and get the sunlight and spend 20 minutes out there. just walking around the yard and it's just so nice to get that sunlight in the morning.

Exactly, yeah, and you want to do it relatively early within 20-30 minutes of getting up and exposing yourself to sunlight is very, very helpful for synchronizing your body clocks.

So that's one reason that people are having so many sleep issues. And what are other reasons people have sleep issues other than the light pollution?

Sometimes it can be medications, medication side effects. Some of the people are taking these stimulants, so I'm tired, so here your doctor gives you Ritalin or Adderall, and then that is a stimulant and it's sort of keeping you up, excess amounts of overuse of caffeine or having caffeine too late in the day. Some people are very caffeine sensitive and they can't have any kind of tea or coffee. Most people in general, I'm going to say that if you have one or two cups of green tea, coffee, and it's early in the day, it's not going to affect your sleep. The half-life of coffee is about six hours. in six hours, half of it's out, and then another six hours, a quarter of it's out. Definitely nothing after noon. Exactly, nothing after noon, exactly.

And most people, it's not gonna affect them.

And alcohol is a big sleep. Oh, alcohol is a big one. In fact, I was telling you about a case. So I had a patient who was, you know, eating late at night. That's another one. That's another one, right? Another one. And that actually, I think, also affects sleep also.

Because when you're sleeping, you don't wanna be digesting. You really wanna be in a fasting state. One is gonna interrupt your sleep, and.

Two, it's gonna make you fat. Yeah, exactly.

That'S basically storing it instead of metabolizing.

That's how Sumos, right? The Sumo diet.

That's how Sumos get fat. They eat and go to sleep. That's right. That was actually a chapter in my book, one of my first books, Ultra.

Metabolism, was called the Sumo Wrestler Diet. Because the Sumos have a recipe for knowing how to put weight on. You eat and go to sleep. And it was a simple patient came into me and they were eating late at night. It was like anywhere between 8 to 10 o'clock at night and they were having a couple of glasses of wine, which, you know, that sounds okay. Well, it was a combination of eating late at night and those two glasses of wine or alcoholic drinks. And very commonly, especially as you get older, maybe after 45-50, you'll get what's called rebound insomnia. So the alcohol sort of relaxes you, whatever, but when it wears off, the brain wakes up. And I started to experience this myself when I started turning 45-50. and so I'm very aware of it.

So any patient-- so you drink wine in the morning.

You drink wine in the morning, exactly. Happy hours at noon.

So no coffee or wine after lunch. Yeah, right.

So one of the things that you do with patients is get them aware of their circadian rhythm, their sleep-wake cycle, the importance of light in the morning, darkness at night, and then also get them off for maybe two months of getting them off of all alcohol and all caffeine and sort of see where their baseline is. See where their baseline is. And then it's for them to decide how much and how often and when to have those things. Which, you know, a good cup of coffee is pleasurable. A glass of wine is pleasurable.

But too much, too late is not a good thing. Yeah. Hey, everybody, 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. Now back to this week's episode. And there are other things that are sort of off the chart a little that people don't think about, but I had severe mercury poisoning and that really interrupted my sleep. So, insomnia can be related to heavy metals and toxins, for example. It can be related to thyroid problems. People have low-grade to low thyroid function, that can be a sleep disruptor. Hormonal issues, obviously menopause is another one. Yeah, menopause. But even like blood sugar issues, people who are diabetic or pre-diabetic, they can get hypoglycemia in the middle of the night, that wakes them up, they get night sweats and hot flashes. So, there's a lot of reasons people.

Have sleep issues that are biological that you can fix.

And even nutritional factors, low magnesium and other factors can be really a big issue.

Exactly, yeah. And it is interesting you say, because there are some people who will have a very big cortisol response at nighttime. So cortisol is the adrenal hormone sort of your get up and go hormone. We're supposed to have cortisol rising as we wake up, and there's a test that we do called the cortisol awakening response. So how much does your cortisol rise as you get up? Well, there are some people that will have problems with cortisol secretion at nighttime when it should be really, really low. And that's another thing that I think is the important thing that interrupts people's sleep is excess amount of cortisol stress hormone at nighttime.

Yeah, that's what my wife yells at me for reading a COVID-19 news at night before bed. She's like, you,'re not gonna sleep, Craig. I'm like, yeah, you're right. But you're right. You don't want to be watching scary things and stimulating things and get your adrenaline up before you go to bed. And I think often we live a sleep-disruptive lifestyle. So we eat late, we drink, we have lots of lights, we engage in stimulating activities before bed.

24/7 news, emails before bed.

We don't do things to wind down. Just having a simple sleep hygiene routine. You know, I'm really ridiculous about this, but at least an hour, maybe even two hours before you turn everything off, you, maybe I take a hot bath with Epsom salt. I put lavender drops in there because lavender actually reduces cortisol levels to lavender essential oils. I've made my room completely black. I have a blackout shade. Even have eyeshades, earplugs if you need them if you live in a noisy area.

Yeah. I use it when I travel.

Blue blocker glasses. So there's a lot of ways to structure your environment so that it's really good, make sure the temperature is right.

Yeah, you just, there's another clinical case. I had this older gentleman who.

He.

Had a whole bunch of different kinds of problems and had probably a little bit of early Parkinson's, mild sort of slowing down. He's in his late 70s. And he on his own, you know, was found out that when he turned the thermostat down from 70 degrees to 64 degrees, he slept so much better. And again, that's the other thing is what happens to animals at nighttime, they're actually out in nature. And guess what? We're animals too.

It's true.

We're actually designed to be out in nature. And that lowering of the temperature also, I think, is very, very good for inducing sleep. And I actually think, this is my own sort of theory, is that when you take the warm bath, and then you go to bed in a colder environment, that shift of the temperature differential. I just get very relaxed when I do that.

True. I mean, the best sleep I had in years was I was doing backcountry skiing with my daughter last year in Utah in the middle of winter, and you're climbing up, exercising, getting up with the hot-- but you're sleeping in an unheated hut, in a sleeping bag, and it's like 30 degrees or freezing. But you got your hat on, you know, like I just love like a baby. And my wife and I have, this is a common debate, she actually had a comedy skit about this, which is, I don't know how she has to go to bed in a winter coat with a hat on. And so we figured out this solution, which is this really cool thing called the Chili Pad. And it's something you can buy, which you put, it's filled with water. It's like a water that goes through it and it cools it. It's like an air conditioned water. And I can have like 64 on my bed and she can be like 75 on the other side and like, it's the best. and I use that and I sleep great because in New York when I had an apartment, the radiator was on, I couldn't control the temperature in the winter. You open the windows too cold. So I had this thing and it was like the best invention ever. And they have ones with different size so you can switch it for the guys. So it's really important to get the temperature right. So there's all these really simple hacks and there's in the show notes for this podcast, there's going to be articles that have a lot of these things in them. So I think it's really important for people to to kind of think about how do they optimize their sleep? Because why is sleep so important and what are the consequences of chronic sleep deprivation?

Sleep deprivation is obviously one of the things is that if you have sleep deprivation, you get angry and irritable. You're very irritable. It actually affects the amygdala part of the brain, the primitive part of the brain that's a sort of fighting kind of a thing.

So when you see people who are chronic.

Was America sleep deprived? Is that the issue here? Yeah. Yeah. Is that hour or so hostile? We might even have the the POTUS might be sleep-deprived.

Well, we know he is.

Yeah, he could very well be. And so, when you don't get good restorative sleep, and they say that seven to eight hours is ideal. There are some people who need more, there are a little bit people who need less. But most of the time, I ask my patients, when you wake up, do you feel like your batteries are charged or do you feel refreshed? That's really, I think, the key thing. also looking at patients, how quickly can they fall asleep? It's not how much time you're in bed, it's like can you fall asleep relatively easily? I had a patient the other day.

Who was like, it takes me two.

Hours to fall asleep. Oh my God. Why is that? Okay, then you got to go down the laundry list. What are you doing at night that may be impairing that? And then you just need to have that good sleep hygiene. It's key.

It's so important. I think we know chronic sleep deprivation affects your mood, causes depression. It affects your risk of, for example, dementia. Your brain can't clean itself.

Exactly. You just brought the next thing. The danger of that is that our brains are about 2% of our entire body weight, but they consume 20% of our energy in the body. So they're highly metabolically active, which means that they also produce a lot of metabolic waste.

Exhaust, basically.

Exhaust, yeah. And the garbage. Guess what? Your brain takes out the garbage at night. So if you're not getting good deep restorative sleep, you can't clean the brain. There's a whole system in the brain called the glymphatic system, which is the lymphatics of the brain that allow you to take those metabolic toxic waste products out of the brain. And what happens is they sort of open up at night as you're sleeping. And if you are not getting good sleep, you're basically not taking the garbage.

Out of your brain. just like nothing in the toilet in your brain.

Exactly.

You know what? For what?

Exactly.

So, yeah, this is really important. So you get, you get increased risk of brain inflammation, increased risk of dementia, increased risk of depression. Your, your cognitive performance goes way down. Yeah. Which is striking. You know, I remember the study I saw of Sharpshooters, like, basically, you know, snipers.

Yeah.

And they're, you know, accuracy was like 99 when they were awake with eight hours sleep and then seven hours maybe it was like 97%. And then six hours like 80%, five hours was like 50%. It was like a coin toss, are.

They gonna hit the target or not? Exactly, and then also the sleep deprivation is worse than alcohol. You're actually more mentally impaired with sleep.

Deprivation than you are being drunk. Yeah, I get that for sure. And I think we have to understand that sleep is not a nuisance or a waste of time. it's something to be cultivated and optimized, and it's critical to your health, your immune function. We're now in this age of COVID-19, and sleep is one of the best things you can do to make your immune system more resilient. So making sure you get enough sleep and understanding how to create the structures for you to sleep well. And then, you know, for those people who are not getting better on the sleep front, even trying all these cool techniques and things we talked about, whether it's the blue blocker glasses or getting their sleep hygiene right or maybe me be using a chili pad and their temperature right, all this stuff. If they're not getting better, there may be other reasons for it. And that's where in functional medicine we dig deep. We find heavy metals and thyroid issues, gut issues, and nutritional factors that may.

Play a role in sleep disruption. Yeah, and the other thing, which, and this is something that's probably not on the radar of most doctors and even also integrative doctors, is EMFs. So, if anybody's gone camping, when you're camping out in the wilderness, guess what? You are not around electrical.

Yeah, that's what happened to Utah, so it didn't have any EMF around.

Exactly, yes, yes. So, when you go out, actually going camping for a week will help to reset your circadian clock. And, I also believe that when you're camping, you're earthing, you're grounding, and you're actually on the ground, literally, and you also are not surrounded by EMFs. And, I do know that EMFs affect our bodies in many, many ways. and I, I don't know.

That's not all hype.

It's not hype at all. I mean, our body, when we measure an EKG, we're measuring electrical signals of our heart. We're measuring an EEG. We're measuring electrical signals of our brain. So our brains are, our bodies are bioelectric beings, and we interface and inter interact with energy signals, whether it's light, sound or EMF vibrations. And without question, they can affect our physiology. Yeah. There's been evidence that EMF exposure can predispOsed towards more autoimmunity. And I do know that when you sleep and you ground yourself, you will sleep better. And my theory is I think it's related to the fact that when you're in a building, you're around a lot of EMFs.

Yeah, my wife got into this.

In New York City, she got one of those. Oh, yeah.

EMF detectors.

Yeah.

And it has this score on it and you can see the green light is okay, yellow caution, red is severe danger. In our apartment in New York, it was severe danger. all the time. And then when we brought it close to our phone or other things or to the Wi-Fi, it would like kind of explode. And she decided she wanted to protect us and she basically created a Faraday cage around our bed. Essentially got a special kind of cloth that blocks electromagnetic frequencies, a special grounding sheet. She hung it over our bed. And if you go in there, you can't make a cell phone call, you can't get on Wi-Fi. You're like, it literally blocks everything out, which is really amazing. So we started using that. in New York because in New York there's so much. You go on anybody's router and you'll see, you know, there's hundreds of Wi-Fi opportunities. Yeah.

And, and I, without, without question, I mean, it's not like you can draw a blood sample or get a urine sample to check EMFs. It's, it's one of those things where you need this special device. And I, you know, this is not voodoo stuff. This is not wacko, way crazy stuff. This is real stuff.

Our bodies are affected by electromagnetic. Some people have more sensitivities. Absolutely. I think there's just like everything, you know, people are more gluten sensitive, people get more EMF sensitive. And I think there's a wide variety.

Of how people respond. But if you're struggling, these are the kinds of things to think about. So, and you think, you know, what do psychiatrists do nowadays to treat refractory depression? They use pulsed magnetic fields to the brain. That's an energy signal, right?

They don't even know how it works.

They just do it. It's like they used to do ECT where they would, you know, paralyze you and then this is a more modern version. Exactly. It's a more modern version. Exactly. But it really shows you that our bodies have an interaction in some type of complex energetic fashion with our body. Yeah, it's so important.

I think we see so many people struggle with sleep. They don't prioritize sleep. They don't understand how to get their bodies to sleep. They don't understand what their bodies require. All the things we talked about from dietary things, whether it's getting off of sugar and starch. I mean, I have so many people.

Do what we call the 10-day reset. which is like a lot of patients love it.

And what's amazing is they report, am I sleeping better? You get off alcohol, you get off caffeine, you get off sugar, you clean up your diet, and all of a sudden your hormones start being regulated properly, your brain chemistry and your neurotransmitters start getting regulated and back in balance, and you start to sleep better and you.

Feel better and you have more energy, and it's like, wow, who knew that all these things were connected? And then the other thing, this is a very important thing is, and this ties in with the coffee, because you and I enjoy a good cup of coffee, The interesting thing about how coffee works is that coffee blocks adenosine receptors. And you were talking earlier about ATP. So, the fuel of our body is ATP, adenosine triphosphate. So, there's three phosphate groups attached to this molecule. And, as we go throughout the day, ATP gets degraded into ADP, which is two phosphate molecules, and then to adenosine monophosphate, and then to just plain old adenosine. as our bodies, and the more you exercise, guess what? The better you sleep. The reason for that is our body has a buildup of adenosine. So as our bodies go throughout the day, we're active physically. It's good to get more adenosine. Dr. The adenosine will slowly build up and then in certain parts of the brain that triggers the sleep mechanism. Dr. Coffee, guess what? If you look at the structural molecule, the caffeine fits into the adenosine receptor.

So that's why it prevents us from feeling tired. Okay, so I just got this new espresso machine. Does anybody in the market for a new espresso machine? So we have a decaf, is that okay?

Yeah, so that's, but again, caffeine can definitely, and actually there's actually some interesting with coffee intake, epidemiologically, a couple of cups of coffee actually have preventive effects for Alzheimer's and Parkinson's. so it's not all bad.

Not all bad.

And the one thing I was going.

To say- It's the dose and the timing.

It's the dose and the timing, like anything. And the other thing that's really, I think, important with coffee is to make sure it's organic, because that's one of those highly sprayed things like strawberries. You don't want to eat them unless they're organic.

Coffee is one of those things, you just don't touch it unless it's organic. Very important. And there's some great companies out there that do this. Purity Coffee is a great one. I encourage people to check that out. And I think we are a society of sleep-deprived people. lack of sleep is a badge of honor. I certainly learned that in medical school. We don't learn how to prioritize sleep, how to practice sleep hygiene, how to identify the things as a practitioner of how to help people sleep. We give them medications. And sometimes medications can be helpful, but they really do create a vicious cycle and a problem.

Yeah, exactly. You're totally right. In fact, there was an article recently that came out with the chronic use of these benzodiazepines, increasing your risk for Alzheimer's. So the sleep medications, things like triazolam and Ambien and those types of things, when you use them chronically, there's actually been an association with increased neurodegenerative conditions, even some of the anticholinergics, which are also used for. So you really, yeah, you want to use them very carefully and judiciously. There are some patients that may have some esoteric sleep disorders, things that we don't quite understand that may need chronic use of those things. But by and large, those things are to be used for a brief period of time, and then there's a lot of other things that you should have in your toolbox to treat.

We do that at the Ultrawellness Center. We use melatonin, we use magnesium, we'll use things like GABA, B6, B12, glycine, we'll use herbs like valerian, passionflower, chlorella, hops, and we often see real improvement with these just simple treatments. I had a patient who was really struggling with sleep and I gave him one of the formulas we use here at the UltraWellness Center and it had melatonin, a bunch of herbs, valerian, this and that, and he said, I'm sleeping great. And sometimes it's really simple. Exactly. I think we need to really focus and double down our sleep. I think people are struggling with sleep out there. There is a way through, there is a way out. There's a lot of great ideas in our show notes. and come with this podcast. I encourage you to, if you're interested in struggling, we'd love to see you at the Ultra Wellness Center. We're doing virtual consults now so we can see anybody, any from anywhere in the world. Dr. Lappe, myself, Dr. Liz Boham, George Papamichael, it's an incredible team. We have nutritionists, health coaches. We have, you know, really great team, physicians assistants. So we really can help you navigate a lot of this and figure out, you know, what's, what's underneath. So if you're not getting better with the typical stuff, it's time to sort of look towards a functional medicine doctor to get help. And we'd love to see you here at the UltraWellness Center.

So any last thoughts, Todd? I'll just end with a quote by Shakespeare, to sleep perchance to dream, aye, there's the rub. And that's what we need to be doing is to be getting good sleep. And also one of the questions I ask my patients is, do you dream? So if you're not dreaming, you're not getting good sleep. And I see that you have your aura ring on. So yeah, so-- you- got a nice color. Look at that. I got it.

And you can actually, the Delta sleep.

Sleep, which is where your body really restores itself. That's a deep restorative sleep, which you can measure. Okay, we should compare notes here.

Yeah, we can compare notes.

Very competitive.

I got three hours. I only got two hours. Yeah, it's interesting. Sometimes I get more deep and more REM and it's like, I can notice how I feel differently.

The temperature makes a big difference. When I drink alcohol and my heart rate doesn't drop down, it's really interesting.

Yeah, and some of these tools that we were talking about that give you a little bit of feedback as far as how your body's responding can be very motivating. So great. So yeah, so there's lots of great tools. We'll put the resources for things like the chili pad and the Aura Ring and True Block Light Block glasses. So all that's going to be in the show notes. We'd love you to take advantage of the things that are going to help you and get better. So if you love this podcast, we love for you to share this with your friends and family. Leave a comment. We'd love to hear from you. Subscribe wherever you get your podcasts and we'll see you next time on the Doctors Pharmacy. Thanks, Mark.