Use FUNCTIONAL MEDICINE To Prevent & Treat DISEASE! | Mark Hyman & Dr. Cindy Geyer

You see higher prevalence of celiac disease and gluten sensitivity in anybody with any autoimmune condition.

There's 80 million people with autoimmune disease. It's three times as much as diabetes or heart disease or cancer. It's massive. From the functional medicine perspective, you know, I approach autoimmune disease really in a very consistent way, which is going down the framework of the matrix and looking where the imbalances are in the body and what are the potential drivers and causes of an inflammation disease. And so I would say, what are the things that you look for, Cindy, when someone comes in with an autoimmune disease like Raynaud's? And by the way, there's 80 million people with autoimmune disease. It's three times as much as diabetes or heart disease or cancer. It's massive, but they're all subcategorizing their specialties. You've got Raynolds, which is a blood vessel disease. You've got rheumatoid arthritis, which is a joint disease. You've got MS, which is a neuro disease. You've got inflammatory bowel disease, which is GI disease. And so you've got all these separate specialists. Nobody's saying, whoa, whoa, whoa, why is.

There so much autoimmune disease? And what do we look at to understand the root causes? So what are the things in your mind that you go through as a checklist if someone comes in with an autoimmune disease? Well, the first step I'm going to go is looking for celiac disease and gluten sensitivity. I mean, that is a do not miss in any anybody with an autoimmune condition. I mean, if you just look at the overlap, you see higher prevalence of celiac disease and gluten sensitivity in anybody with any autoimmune condition. I mean, we've talked about this before with Sydney Baker's TAC rules. If you're trying to control the autoimmune condition, but you're sitting on that gluten TAC, it's going to be really hard to quiet everything down and feel good. you have to remove the driver of the inflammation and the autoimmune up-regulations. That is the first place that I go.

Before you go on from that, I want you to explain the rest, but I just want to emphasize that because, you know, when someone comes with an autoimmune disease, getting a celiac panel is like checking your blood pressure. It's just the most basic thing you can do. And often people misinterpret it because the levels are Normal, but they might be in the continuum. So what if normal is up to 20, but your level's 18 or 17 or 15 or 10? Is it relevant? And the answer is yes, it's relevant because it means your body's having an immune response to an antigen or a foreign protein in the gluten that you're absorbing across your gut and your immune system is seeing and then getting pissed off about and creating a systemic reaction around. Now, how bad is that reaction? Will it cause symptoms? Do you feel bad? maybe, maybe not, but it is causing some low grade level of inflammation and it's a low grade hidden inflammation that's driving so many chronic diseases.

Right, I think that's a really important point and it's another one of those that sometimes doing more in-depth testing, somebody might say, well, I don't have celiac disease, but every single other gliadin or gluten protein is showing up elevated. That might be a big motivator to say, all right, I guess I do need to stop eating the bread and remove the gluten from the diet. So sometimes we do more testing to convince people or really engage them because it's hard. If those are foods you love, it's hard to get people to give up what they're used to eating.

Absolutely. Yeah, absolutely.

And of course there are other foods that could be culprits too, but gluten is the number one in my list.

So go through now the rest of the kinds of things you think about with an autoimmune disease.

Yeah, so I also think about gut health and the health of the intestinal lining because anything that disrupts the health of that lining creates more input to those antibody-producing cells. And I think if we quote Alessio Fasano, unlike Las Vegas, what happens in the gut doesn't stay in the gut. If it's not healthy, if that wall is more permeable and there's more bacterial proteins getting into the bloodstream or more food proteins getting to the bloodstream, there's that immune system just going, ahh. And it's not just acting at the gut level. It can start cross-reacting to organs that we should normally be tolerant to. hence an autoimmune condition. So we really want to understand the health of the gut microbiome, the integrity of the intestinal lining, how well are we digesting and absorbing our food? Do we have an overgrowth of bacteria in the small intestine?

That's the second priority. Yeah, so you've got gluten, you've got the gut microbiome, you've got leaky gut. What else goes through your mind when.

You see someone with an autoimmune disease? Well, so you also think about whether there could be a toxic insult, a toxic exposure. that could be up regulating the immune system. We know that, and I won't say that stress per se necessarily causes an autoimmune condition, but it can certainly perpetuate the cycle of inflammation.

Makes it worse for sure.

Makes it worse, just like sleep deprivation, same thing.

Yeah, so toxins, like you said, are actually immunogenic and there's a word for the role of toxins in autoimmune disease. They're called autogens. it literally causes an autoimmune response in the body, whether it's pesticides, heavy metals. And I've seen this, and I'm sure you have, Cindy, many times in your practice, and you never know if it's that. Or. So we've gone through the gluten, and we, we've gone through the microbiome, we've gone through toxins, and there's a few other things I think about, like food sensitivities besides gluten that can be a play role, which just goes along with a leaky gut. And then the last thing I think about are, are. infections that are infections. Because we often ignore those and the bodies, you know, you're, you're living as a host to all sorts of bugs, right? And when you have AIDS or HIV, you don't die from the AIDS virus. You die from all the latent infections that you actually have already living in your body, like pneumocystis or Candida or CMB or tuberculosis or whatever you've got kind of laying around. It's just your body's handling it's, it if that's what kills you. And in the autoimmune disease, I think there's an unrecognized role of infectious disease. And there is some literature about this for sure.

Absolutely.

What was interesting to me is that nobody chases it down. So even though if you look at the PubMed, the National Library of Medicine, you look at all the data on autoimmune disease, you can type in autoimmune disease and toxins and diet and gluten and allergens and Lyme disease, and you'll find all these papers. But what's striking to me is that that when you go see the rheumatologist, they don't go, oh, we should look for these things. They just don't. Sometimes they'll check a celiac panel. That's actually more common now. But they don't really look at diet, they don't look at toxins, they don't look at allergens, they don't look at.

Latent infections, and you'll often see dramatic improvements when you actually help people with those issues. Well, you know, Mark, it's interesting. When we were in medical school way back in the day, we learned about writer syndrome, right? Writer syndrome were where people would show up with symptoms like rheumatoid arthritis, hot swollen joints and positive rheumatoid markers, and it either came after a gut infection like Shigella or Yersinia, or it came after a genital urinary infection like chlamydia. So we knew even 30 years ago that those infections can actually trigger an autoimmune reaction. That's right. And more recently, there's been a link with Porphyromonas gingivalis, so an oral bacteria and rheumatoid arthritis.

So, if you have bad teeth, that can also be a source, right?

Yep, yep, which I didn't mention.

So, absolutely. So, if someone comes with Ray nodes, you're thinking about all these things in the back of your head and you're wondering, oh, what's this person's story? And you go into their story and you can usually ferret out what the issues are for them. And then you can start to chase down the things that are really abnormal. So, tell us about Ray nodes, how common is this problem? What are the symptoms? And what is the general approach with traditional medicine?

Sure. So you talked a little bit about the sentence that it's typically fingers, sometimes toes, sometimes nose, turning white in the cold. And then when they come in, and it can be very painful, and then you come inside and as it warms up, they can turn beet red. So it's small arteries that react to the cold. And there are two types of Raynaud's. There's primary Raynaud's, which is just the Raynaud's by itself.

Of the biology of it, you know, you're getting these sort of contracted blood vessels. What is the cause of that?

Well, we don't know 100%, but those arteries, if we think of the importance of artery elasticity, so your arteries are dynamic. They can dilate and they can constrict when needed. Sometimes it's a way to kind of maintain core body temperature. But those small arteries in particular, we think of that inner lining, the endothelium that's responsible for regulating the tone. It is another one of those proverbial canaries in the coal mine. It's affected by a lot of other things besides cold. In fact, it's affected by many of the other factors that increase our risk of cardiometabolic disease. We know that arteries can spasm in response to an unhealthy diet or hydrogenated oils. We know that arteries can spasm in response to stress or sleep deprivation. Arteries can spasm in response to air pollution. So there are many, many other factors that will make maybe a predisposition become more significant and more relevant. And the other piece is there's some evidence that if you have arteries that are prone to spasm, It may be a marker that you are at higher risk down the road of developing high blood pressure, heart risk, and stroke. So it's really a time to pay attention to the health of your arteries.

So it could be found in isolation just as a random condition, quote random, or it can be associated with other autoimmune diseases that people have like Sjogren's or lupus or other conditions. Essentially it's almost an autoimmune disease of the blood vessels, right?

Right.

And it creates inflammation. So then the question is, you know, how do we think differently? You know, if you're just giving drugs like Viagra or you're giving drugs to, you know, like increasing blood flow like blood pressure pills and so on. What do we do differently in functional medicine? How do we think differently about this problem? What are the diagnostic approaches we use to test and figure out what the cause is and what do we do in terms of treatment?

Well, I think it's important, number one, to really do a deep dive into vascular risk measurements. We want to know somebody's quality and quantity of cholesterol. We want to know their glucose and insulin and how they're able to manage glucose. We want to know their inflammatory markers like their C-reactive protein. And do they have evidence of oxidative stress? Anybody with an autoimmune condition, Mark, I mean, you've talked about this for such a long time. We want to figure out what the underlying causes that's up regulating the reactivity and leading to the autoimmune condition. So we want to look for food triggers. We want to look at the health of the gut lining and all of the other things that people are familiar with. So it's really looking for upstream to see from a vascular standpoint how healthy that is and what's driving it. And from driving and up regulating the immune system, what we can identify and remove and address.

How do we assess people? Is there a test for a Reyno's or is it just sort of looking at the symptoms?

You know, it's primarily a symptomatic diagnosis, to be honest. There are tests you can do to look at artery elasticity in general. They're not widely available, but some places will do them. They're usually done in the context of cardiovascular disease to look at how resilient the small arteries are. There's one by a company called Itamar based out of Israel called an Endopat. I don't know if you're familiar with that one. It's not very comfortable. They basically put a little probe on your finger and pump up a blood pressure cuff to block the blood flow for two minutes and then measure how quickly it takes for the blood to get back to your finger when they let it down again. So they can tell you about the small arteries.

It's like medical torture. Well, that's fine. But then it doesn't really tell you why. It just tells you they're not working. What's not working, which is what we're really good at in medicine is figuring out what's not working, but we don't know how to figure out why it's not working. We know what's not working, but not why it's not working. And I think that's the beautiful thing about functional medicine. So, and I've seen, you know, patients with Reynold's, when we start to dig down on these issues, we look at toxins, we look at gluten, we look at their microbiome, we look at allergens, we look at food sensitivities, we look at infections. We can really start to ferret out what the issues are and often get.

These people a lot better. So, what is the approach then from a functional medicine perspective?

For Raynaud's syndrome.

Yeah.

So from a diagnostic standpoint, as I mentioned before, we want to look at all those cardiometabolic risk factors. We want to look for the underlying tax that they're upregulating the immune system, whether it's gluten or food sensitivities or something going on in the gut microbiome or an infection. And then from a treatment standpoint, a lot of the same lifestyle things that we normally want to do specifically help those arteries be more resilient, less reactive. So we know, for example, that studies on meditation and yoga biofeedback can show improvements in Raynaud's and artery elasticity after six weeks of a regular, consistent practice. Wow.

Just yoga practice.

Right.

It's great. So you can, you can basically meditate your blood vessels healthier.

Right.

That's good.

Yeah.

Who, what was that story years ago of somebody meditating and they could change the temperature in one hand versus the other?

Yeah.

Yeah.

Five degrees or something incredible.

Yeah.

So we have more control over that.

Autonomic nervous system than what we thought. You know, I've often find any other things around diet or supplements helpful for these patients?

Yeah, there's a lot. So again, specific food components, omega-3 fatty acids have benefits on artery elasticity, whether that's fish, fish oil, nuts and seeds. You know, arginine is an interesting amino acid. It's used by the arteries to make their own version of nitroglycerin. So it's a precursor of nitroglycerin, which of course dilates Nitric oxide. Nitric oxide. Yes, thank you, nitric oxide. So getting nuts and seeds or maybe even supplementing arginine, the deeply pigmented foods that are rich in bioflavonoids, a lot of those polyphenolic foods also relax the arteries. Things like resveratrol, for example. Folate-rich foods, dark leafy greens, another powerhouse for the arteries. so if we think of that extra virgin olive oil, another food that has natural benefits on relaxing the arteries. So, yeah, that's really a lot of what I use.

Cindy and I often, you know, I'll supplement with arginine. They're very symptomatic if they're going out and often even ginkgo, which is a, another product. But I think the nitric oxide is interesting. You can increase nitric oxide by your breathing, too. Just by eating practices we, we had Luis Ignarro on our podcast who won the Nobel Prize for his discovery of nitric oxide in its role in improving overall health, reducing inflammation. And it's incredibly important for lung health as well. And with COVID they're finding nitric oxide being very effective in treating COVID patients. And he talks a lot about that on the podcast. But the nitric oxide can also be increased by Viagra or Cialis or any of those drugs that are used for sexual enhancement, but they actually work by increasing blood flow and circulation. So that's a good thing. So, you know, maybe if you have Raynolds, that might help as well. So, arginine you can take, or you can do those drugs, or, you know, you can actually use Ginkgo and other things. Bioflavonoids I used to use quite a bit. And combining that with the root cause, the medical detective piece, because you can't just give those, someone's got Raynolds, oh, give them arginine.

No.

Well, why is it have Raynolds? Like, what is the cause? What is the root? And I think that's what often people miss, even in integrative medicine, they'll say, oh, well, you have rhinos, use arginine. I'm like, no, no, no. Why do you have rhinos? Like, what is the root cause? And this is the part that we often miss in medicine. And that's why the Ultra Wellness Center, we really have such a robust practice, because we are the medical detectives looking for the root cause. You want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks. where I share my favorite tips for health, longevity, well-being and lots more. Check it out and the link below. You know, I just tell you, I just had like an anecdote of a patient I just had this week that was just, you know, it's one of those stories. He's really awesome guy and he developed a tick ticks when he was not tick bites, but he developed like motor ticks, you know, when he was eight. And I started asking about his story and his doctor was nothing you can do, take these drugs, whatever. so I said, well, what was it like? What was happening? Did you get infections? Did you have this? You have that? So I started digging into his story. He had tons of infections and strap.

And all kinds of things.

And, you know, we know there's a syndrome called pandas, which is pediatric autoimmune disease of neurologic, blah, blah, blah. I don't forget what it stands for, but so long. And, and, and that is associated with strep infections that cause behavior issues, OCD. tix. And when I checked his labs, he had super high antibodies to strep. And on the Cunningham panel, he had really high antibodies against some of the components in his brain related to strep. And yet no one had even thought to ask the question of why. And so whether it's tic disorder or whether it's Rayno, whatever, you, you should get, if you get into the habit of thinking, which is what I, I love about functional medicine, because it makes you think. as opposed to just sort of rote memorization and knee-jerk reaction. That's sort of what we get in medicine, which is we make the diagnosis, then we don't have to think anymore. We just basically say, here's the cookbook protocol that is in 2021 for XYZ disease. And functional medicine is different. We have to start thinking. We call it thinking and linking. We know why your fingers get cold and turn white and you have no circulations, because you have Ray nodes. Like, no, that's just the name of what it looks like. That's the name of the problem. It's not the cause of the problem, right? And so that's what's so beautiful about functional medicine, is you get to actually go into thinking and linking with what Sid Baker talks about, this whole idea of thinking and linking and changing the way that we actually approach diseases by once we get the diagnosis, that's the beginning of the process of thinking and connecting the dots and being a medical detective. And that's what we do in functional medicine.

Hey, YouTube, if you like this video, you're going to love the next one. Well, I think the first thing to think to talk about is cholesterol as a risk factor for heart disease. So LDL is so called bad cholesterol as everybody, everybody knows about this. I mean, the campaign has been so good, so strong that everybody around the world, when you mention cholesterol, there is an element of fear when people are told about high cholesterol or they and they immediately associate with heart disease.

So LDL cholesterol was sanctified as a major risk factor for heart disease. And most of I love that word, sanctified.

Absolutely.

Like a priest.

Well, no, in a way, there is almost a very strong belief that getting your LDL lower is the way to combat heart disease. But if you look at the original Framingham data, to Framingham in the United States, which was a town where several thousand people followed up over decades to look at risk factors for heart disease, High cholesterol was one of those risk factors. When they looked at the overall data, they realized that the most reliable risk factor for heart disease from cholesterol is your total cholesterol to HDL. So, total cholesterol divided by your so-called good cholesterol, HDL, LDL, the other new feature. Now, William Castelli, one of the co-directors of Framingham, he looked back in 1996 and published a paper in atherosclerosis. And even I found this extraordinary mark. He wrote that unless when they looked at the data from Framingham, unless LDL was above 7.8 millimoles, which I think in your terms in the States, I think is well over 250, probably over 300. Unless it was over that value, in isolation, it was essentially useless as a biomarker in predicting heart disease. I mean, that's extraordinary. Most patients we see, Mark, don't have LDLs anywhere near that.

Unless they have a genetic disorder.

Unless they have a genetic disorder. So, people with what we call familial hyperlipidemia. And we know from the data that people have genetic where their cholesterol is high, then which affects less than 1% of the population, probably anything between 1 and 500 and 1%. 70% of women with untreated FH will have a normal lifespan and 50% of men. So actually there is a huge proportion that will be have premature death because of heart disease. But what's interesting is there is now data to suggest, well, is it the cholesterol or is it something else that's going on? Now, when you look at the lowering of cholesterol, of LDL specifically from lots of different drugs, including statins, when you look at the totality of data Mark, actually there were 44 randomized control trials, both mainly involving drugs, also involving diet, the very robust studies in themselves had no reduction in mortality, no reduction in CV mortality, cardiovascular mortality. Most of them had no reduction in any event reduction, even non-fatal heart attack or stroke, and some showed harm. and that in, that information and evidence is being ignored now. Okay, let's talk about statins. What does the totality of data tell us? And I'm going to bring in some caveats as well, because what I'm saying to you now, I often have this conversation with, before you dig in there.

I just got to go back because that was sort of breathtaking what you just said, which was that 44 randomized trials lowering LDL cholesterol with lifestyle or diet had no impact on heart attacks, death, or any.

Well, lowering cholesterol, a lot of those LDL. And what's interesting is there was no also link between how much you lowered the LDL and whether it was an event reduction. Because there is an academic community out there that believe the lower the better and papers are published, which in my view is selective reporting and cherry picking data and making it look as if actually the lower your LDL, the greater benefit you have. The overall totality of the data tells us that is false. Amazing. Absolutely false. Now, when you look at statins and one of the websites I actually tell my patients to go to, which is great, it's an independent website called bnnt.com.

I wrote about that in my book, In Fact, Get Then, right?

It's fantastic, isn't it? And it's useful because this website is created by independent researchers. There are no conflicts, there's no funding or advertising, and they synthesize all the best high-quality data and put it together to basically calculate for patients what is important outcomes to them, but also for doctors. So, for example, heart attacks, deaths, those are the most important outcomes for most people from taking a drug. That's what they want to know. And when you look at the totality of the data on the nnt.com and all the statin trials for people with heart disease, so we'll come back to healthy people first, but people with heart disease, your mortality benefit, if you take a statin religiously every day for five years, your mortality benefit is one in 83, as in it will, there's a one in 83 chance it will delay your death. Listen, we're all going to die.

That means 82 people will take statins with no impact.

And no impact on their mortality. And about one in 39 to prevent A non, say a recurrent non fatal heart attack.

That's if you've already had a heart attack.

Yeah.

Then you have to treat 39 people.

Before you prevent another heart attack. Prevent another heart attack.

One heart attack and 83 before you prevent one death.

Now what I say also to my patients, this likely represents even the very best case scenario because all of the data on statins essentially comes from industry sponsored studies. And not only is it industry sponsored studies, but when you look at the patients or participants in them, It's known now that the side effects are underreported and many people who either experienced side effects before the trial started or had characteristics that made them likely to get muscle symptoms, because that's the most common symptom we see, actually were taken out of the trial. Now, when you look at the real-world evidence mark in community studies about statin prescriptions and patients taking statins, in the United States, the statin usage survey, which is over 10,000 people, surveyed, I was flabbergasted myself when I saw this statistic because this statistic, which I'm about to tell you, is based upon people having no, this is before any media scaremongering or awareness about side effects. So these are people who are most likely being prescribed by their doctor in the community to say, this is like a magic pill. It's going to reduce your risk of heart attack. 75% of people prescribed a statin in the community will stop it within a year of prescription. And when asked why, 62% of those said it was because of side effects. And many of those tried different statins that have the same problem. The side effect most commonly reported is fatigue and muscle pain. Now, that is a huge discrepancy mark between the clinical trial data, which tells us really less than 1% really get muscle symptoms, maybe one in 10,000 get a serious myositis. It's a huge discrepancy mark between the clinical trial data and what we experience in the real world. Now, I'll tell you something else very interesting that most people don't know. People think conventional wisdom, even I thought this, in fact, I published a paper, where I even said statins have reduced mortality and secondary prevention in the population. I didn't use a citation. It was just my understanding that it had done.

A dogma you learned from your- what's that?

I just presumed in secondary prevention because in the trial data there is benefit, but it's very small, really, for many people.

Well, right, I always say it's absolute versus relative risk. The risk goes down by 30%.

That means it's going down from 3% to 2% in the population. I know, I know. And absolutely. And in fact, we should be having that conversation with patients because if you don't, then you're being non-transparent in your communication of risk, and that will exaggerate the benefits and often minimize the harms because of under reporting.

But actually- I think it was Roger Williams or Mark Twain said, there's liars, there's damn liars, and there are statisticians.

Who can manipulate the data to say whatever they want. Exactly, that's another concern, isn't it? But when you look at the, there was a study published in the BMJ in 2016, and they looked at Western European countries over 12 years and looked at cardiovascular death rate reduction from statins in different risk groups, including secondary prevention, no reduction in death rates and cardiovascular mortality in the middle-aged.

Even with people who are the most likely to benefit from statins, which are.

High risk who've already had a heart attack. How do you explain that? Well, from a scientific perspective, I can explain it. Even if we presume that the data is absolutely correct from the trials. So, another way of looking at the statistics from the trials on statins in people with heart disease is that if you take a statin every day for five years, what's your median, which is a crude way of saying average, not exactly the same, but what's your median increase in life expectancy for taking a stand? If you've had a heart attack every day for five years. And when I ask the audience and ask people this, they come up with figures like they'd add five years to your life, several months, whatever, 4.2 days.

4.2 days.

And that's if you average it all out.

And those days are typically with muscle pain.

Well, you do actually probably people who haven't, who have tolerated the drug. But what it tells me is if you think about that, and you also realize more than 50% of people over the age of 65 who take a statin with heart disease, Mark will stop the statin within two years. This is people who have had heart attacks. Again, because of muscle symptoms, you can understand why there is no reduction in the population because actually many people stop taking their statin. The benefits are marginal anyway. Do I think statins work? I think probably yes, but in such a small number that actually in the real world, the benefit really, it's failed. It's failed to reduce heart disease. I mean, the reason we still have an epidemic of heart disease and it's still the number one killer Mark, you know, there was a prediction by people pushing the cholesterol hypothesis. And when statins came on the market, that we would end heart disease, the epidemic by the 21st century. And we haven't. And the global, you know, campaign has failed. One, because the drugs are not as effective as we thought they were. Two, because side effects are real and underreported, but in the real world, people stop taking their drug. And three, the cholesterol hypothesis itself is flawed because it's not the most important risk factor for heart disease, which is insulin resistance. Now, Ancel Keys told the New York Times, this is the man who was the most influential man in many ways in nutrition and medicine.

He was the guy who said we.

Should cut out fat and saturated fat. Absolutely. The Seven Countries Study author influenced the guidelines in a big way, probably more than anybody else. In 1987, he told the New York Times, I've come to realize cholesterol is not as important as we used to believe it was. I mean, the fact that he says.

That is a big statement.

I mean, you look at the fasting.

There'S a Jupiter trial where we found that the statin drugs may not act by lowering cholesterol or LDL, may act by other factors such as anti-inflammatory factors or antioxidant factors. And in the study where they looked at lowering LDL, if they didn't lower inflammation levels, but they lowered LDL, there was no benefit.

Only when the inflammation went down was there benefit. That's extraordinary, Mark. You're right. And in fact, my BMJ saturated fat piece in 2013, I postulated that as well, that my own personal view. And in fact, I was also reflecting the view of my cardiology colleagues as someone that's treated thousands of people with heart disease, done over a thousand angiograms and treated people with heart attacks and has been on the ward round after people coming with heart attacks and the wards. We prescribe statins like smarties. We put everyone on a high dose. We rarely even check cholesterol because the guidance was saying, doesn't matter what the cholesterol is, get them on a high dose statin. I would be the guy, Mark, In the ER, in A&E, we say in England, in the US, we say ER. I would be the guy when the chap's been diagnosed with a heart attack before we take him even to the cath lab. Throw it down to statin. I'm telling the nurse, give him 80 milligrams of torvastatin. Because I genuinely believe that the effects were immediate and it was anti-inflammatory. Interestingly, when you look at the data, actually there is no acute benefit from statins at all for event reduction. For several months, no benefit in death rates, event reduction. if you're a patient and get side effect within a few weeks of taking a statin, stopping a statin certainly is not going to increase your risk of death or a heart attack at all.

And, you know, you're talking about these side effects, but the way they work is inhibiting an enzyme, HMG-CoA reductase, which also produces something called CoQ10 or coenzyme Q10, which is an essential part of making energy in your muscle cells and all cells. So when that gets blocked, not as a side effect, but as an effect, it leads to a reduction in energy production. So it's like you just ran a mile or 10 miles as fast as you can and you get muscle pain. And that's what happens to these people. And it also affects the brain. It also affects sexual hormones because your LDL and your cholesterol is what you make testosterone and other hormones from. So these are not side effects. They're effects and they may affect different people differently. And there's a lot of genetic variation in this, but the whole philosophy of driving down LDL as low as possible doesn't seem to make sense. These new drugs, these PK whatever C-19 things, they are dropping people's cholesterol to seven or 10 in LDL. And then does that make sense?

No, it doesn't make sense to me at all. In fact, I was part of a team of people that published a systematic review in the BMJ specifically looking at people over 60 to see the association of LDL. How strong was the association with LDL and heart disease? and we were even quite shocked by the findings. There was no association with LDL and heart disease, and there was an inverse association with all-cause mortality. How do you explain that? Well, we know cholesterol is a vital molecule in the body. We produce it for a reason. Without it, we would die.

It's not bad. It's just there are certain forms of.

It that are worse. Absolutely. And probably influenced by various factors. Like sugar. Absolutely. And when we looked at that, there was good data to suggest that cholesterol is involved in the immune system. Elderly people are particularly vulnerable vulnerable to dying from infections such as pneumonia or, you know, stomach infections. And it's probably the mechanism is probably protective in the elderly because of their protecting you from those infections. So I actually say to some of my patients that have come in who have, you know, patients have been referred to me by their general practitioner, a lady over 60, for example, with a high-ish LDL and said she was very worried. And she came in the room with a look, you know, looked like she'd seen a ghost. She was so fearful. because she thought he was going to have a heart attack. And I said, congratulations, you're going to live longer. And I explained it all to her and she walked out my consultation room with a smile on her face.

Well, it's true. The Honolulu Heart Study was fascinating where they found that actually the higher your.

Cholesterol as you're older, the healthier and longer you lived. Yeah, it's extraordinary. So I think the paradigm needs to shift, Mark. And I think when you look at the data that's there, and I published an editorial with Rita Redberg, who is here also for the conference, and Pascal Meier, both editors of medical journals, both practicing cardiologists, we said the paradigm shift needs to happen where we need to concentrate on really reducing insulin resistance, which is, you know, really the number one risk factor for heart attacks, certainly in young men. And, and actually that would actually tackle many other chronic diseases because it's a precursor for type two. It's responsible for 50 to 70% of people with high blood pressure. And, Mark, I am, you know, advising many patients to follow a low sugar, low refined carbohydrate, what I call a high fat olive oil based Mediterranean style diet. and people are coming off their blood pressure pills within weeks to months. No, we see- Cardiovascular risk markers are improving. They feel better. It's extraordinary now. Okay, let's critique it. Have we got long-term data to show that from randomized controlled trials to show this Mediterranean lifestyle approach is superior and going to reduce death rates? We don't, and we need more of that. However, their risk markers improve. There's no side effects. Their quality of life gets better. and if they come off medications, it's a win-win for the patient and for the healthcare system. Right.

It's biology. So you just mentioned something that I think is sort of the flip side of the story, which is insulin resistance. And that is a mechanism in the body that happens where your body becomes numb to the effects of insulin when you eat too much sugar and starch. And it turns out that all the separate diseases we see may be linked by this one common mechanism. heart disease, many cancers, type 2 diabetes, obviously obesity, even things like dementia, which are now called type 3 diabetes. These are the major killers. They're all driven by the same mechanism. Now, if that's true, you know, you know, we are living in a society where we're all at risk because sugar is everywhere. And you've been the, one of the most vocal proponents of sugar sort of, you know, you sort of remind me a little bit of Jamie Oliver, you know, who, who's a chef where he, on his Ted stage, poured out, you know, like a whole wheelbarrow of sugar and said, this is what we're eating in a year. And you, you've been very active about this. And you wrote an editorial recently in the Journal of insulin resistance called the science against sugar alone is insufficient in tackling obesity and type two diabetes crises. We must also overcome opposition from vested interests. So this is a very powerful statement. So it's not just a matter of science, it's a matter of politics and our policies that are driven by the food industry. And you're taking this head on. Tell us what are the biggest drivers in that and how do we begin to deal with those?

Well, I think you're right about sugar being, I describe it in an article I wrote in the Observer newspaper that it's public enemy number one in the Western diet. It's become so prevalent because it's been added to so many processed foods in the States. It's estimated 50% of foods that people don't think are junk foods have added sugar in them. And our estimates suggest, you know, in the States and in the UK, people are, on average, are eating anything between 20 and 25 teaspoons of added sugar in their diet day, which is extraordinary.

Now the- and kids are about 35.

Yeah.

And, you know, and the recommendations from the World Health Organization now who are put under pressure sugar, say maximum limit of six, but they say limit. They don't say you should have it because actually for optimal health- that's the upper limit. You don't need any added sugar in your diet. I mean, there's no nutrition in it.

There's nothing.

It's a tree- There's no biological requirement for sugar. Or sugar or carbohydrates, by the way. Well, you're actually right. There is actually no essential requirement for carbohydrates either. But with sugar, yeah, you can get, you know, you can very easily have.

A very, very healthy life with zero sugar in your life.

Now, when we wrote this piece- I.

Would rephrase that, you will have a very healthy life.

You're right. It might take you a few weeks to reach that point. You might be a little bit gnarly for a while before you get there when you're breaking the addiction, but yeah, no, you're absolutely right. And so the first thing to say is, well, how do we combat this? And we can learn from lessons. We need to learn from history, Mark. If you don't learn from history, you're bound to live through it again. And I think in some ways we're doing that because tobacco, big tobacco, we're able to stall what we call effective population interventions to reduce tobacco consumption by really adopting a strategy of denying cigarettes were harmful, planting doubt, confusing the public, even buying the law to of scientists who would write papers and not declare they're taking money from tobacco, saying they don't think tobacco is harmful. and they did this for 50 years from when the first links between smoking and lung cancer were published. And actually, when you eventually, when we did manage to reduce tobacco consumption, which.

Was actually- Only through a lawsuit, wasn't even a government policy.

And ultimately government policies followed, but it was, you know, I talk about the three A's in public health, tackling the availability, the affordability and the acceptability. So public education campaigns, cigarettes are harmful, banning tobacco advertising, smoke-free buildings, when you combine those, that was responsible for most of the decline in death rates, cardiovascular mortality in the US and the UK and Western European countries, certainly in the last sort of 40 or 50 years. And that is actually what's most the biggest decline was only when regulation was introduced, really, from governments, because governments have a duty and responsibility to protect citizens from excesses and manipulations of industry because ultimately, people were lied to. People were lied to. People were misinformed. They were making decisions about their health based upon misinformation that was coming from industry. And actually, government had to intervene. And when the science was there, that wasn't enough, you know, because there had to be a battle. There were campaigners and people had to keep pushing this message. And we see the same sort of things, which we have to realize the same sort of things exist with sugar.

Because- Tim Donnelly: -They're in playbook.

Playbook.

There's a playbook. And they often were the same company.

But Mark, yeah, exactly. But we've also got to have it. We can't be naive about this. There are, you know, they're very powerful vested interests. There's a lot of money invested in flawed science, in, you know, pushing a message or a hypothesis that's so flawed and harmful, you know, that people make a lot of money out of this. I mean, the cholesterol, fear of cholesterol, lowering saturated fat, I mean, it's a multi-billion dollar industry that profits from that message. So it's not going to change overnight. and what industry do and people who support industry, who get funding from industry, often not obvious or declared, they will engage in tactics to go after people like me or other public health campaigns.

Or like me.

No, absolutely. This is, you know, we are here trying to push a message of truth and transparency and openness, and we will get called names. We will say that what we're promoting is junk science or whatever we reference in terms of design. This is what they do. This is the science.

There was an article about me in Forbes magazine. totally discrediting me. And I read the author was part of this group called the Genetic Literacy Project. And as I began to dig into that, it turned out that's fully funded by Monsanto. So, wonder about the credibility of that story.

No, sure. And Mark, you know, this is an important point for journalists as well, because actually my view is this, there should be full declarations of interest in terms of financial interests. specifically, you know, before people are asked to comment. And I think this even applies to scientists because otherwise, I mean, it makes a big difference. It's a huge bias. It doesn't mean they can't comment, but people need to know that these people really are acting as frontmen for industry interests. Because if we don't do that, Mark, we're not really adhering to what I believe are true principles of democracy, because people wouldn't change their opinion in their decision if they know somebody who's giving them information. is being funded by the very organizations that profits from what they're telling us.

So true. Coca-Cola is funding research on soda and obesity. Of course, it's going to find that it's, you know, not harmful. And you mentioned this article that there were 128 articles and 471 authors that were not disclosed by Coca-Cola and 19 academic investigators who we think are independent had direct email contact with Coke. That's completely unethical. Yeah, absolutely. And it's not actually reported in the studies.

Yeah, so it's not reported in studies, but I'll add something else onto this, which is interesting, is that I think declarations really important. But actually, they're always a footnote at the end. They aren't the headline. They're not mentioned in the news stories. And actually, declaration doesn't remove bias. In fact, there's one in one of the law journals. It was a very interesting article that showed that it can actually exacerbate bias sometimes. So, an audience listening to a speaker who declares his interest in something, initially the credibility momentarily may drop slightly. But then what that does is it gives the speaker, the person with the vested interest, a moral license to exaggerate their claims even further. So actually there's no net reduction in that. In fact, it can sometimes make things worse.

And so the implication is, well, I'm supported by them, but I'm independent in my opinion.

Yeah, and because I'm declaring it, you can see this, and then that then gives them that they're done, let's just move on. And in fact, actually, it doesn't, the declarations are extremely important. I think that is something we need to adhere to for everybody, every scientist, everyone who's publishing something, but it does not remove bias.

Yes. No. So what are the other things that are happening besides the scientists being corrupted? The public health experts being affected by this?

So I think the- what- so you.

Talked about Brenda Fitzgerald, who was the disgraced director of the CDC, which partnered with Coca-Cola when she was Georgia's public health commissioner and bankrolled something called the Global Energy Balance Network, which was a consortium of three academic that said that actually it was all about calories in, calories out, and that exercise was the solution. And eventually they were exposed by the New York Times and said, well, we have to shut down the global energy balance network because we have resource limitations. I don't know if Coke has resource limitations. It's surprising to me, but I thought that was fascinating. So that's just as sort of the tip of the iceberg. You've got a woman who's running the Center for Disease Control, which is the nation's most independent scientific public health organization, partnering with Coca-Cola to push a concept that's not found in science, that all calories are the same and saying that we should focus on exercise.

It is extraordinary and it's sad. And I think Brenda really is just a product of really a system failure, Mark, because because, you know, really in this battle against misinformation, the greatest weapon we have is transparency. The more of this, people need to be aware of it because most people wouldn't accept this then as being independent advice. But, you know, when I look at the situation as it is, we've got to understand as well that these industries, whether it's the drug industry or the food industry, they're there. They have a fiduciary obligation to make profits for their shareholders. They're not, you know, pharmaceutical industry don't have a fiduciary obligation or legal obligation to give you the best treatment, although most people think that would be the case. The food industry there to sell food, not look after your health. And they can mislead and market and-.

They talk about getting more stomach share.

Yeah, absolutely. But the real scandal, Mark, is that those with a responsibility to patients and scientific integrity, that includes academics, medical journals, institutions, they collude with industry for financial gain. And that's the real problem we have. And we talk about government guidelines and we realize, for example, for example, I was part of this campaign to get sugar reduction down in the UK. And when I came out and wrote an article in the BMJ saying the dietary advice on added sugar needs emergency surgery, where I had from my own investigation figured out that in Europe, people were effectively being told from sugar labeling of sugar on products to consume as part of their healthy diet, guideline daily amount, 22 and a half teaspoons of sugar a day. And I thought, how is there a recommended amount? It's crazy. I'm a practicing cardiologist. I'm not a nutrition scientist. I had to do all this research on my own. And then I asked the Scientific Advisory Committee on Nutrition. They're basically the academic group that advise government and producer guidelines that they need to sort this out quickly. And eventually they succumbed. But they only succumbed after an investigation by Channel 4 Dispatches program and the Sunday Times newspaper in the UK. Interestingly, they were exposed that several of the members of this panel had direct financial, institutional, personal links to manufacturers sugar, big sugar. That just doesn't make any sense to me. So, am I saying these people are corrupt? No, I'm not. I'm saying that there is a bias there. And I think that when it comes to giving advice that influences millions of people that is supposed to be independent, it needs to be independent. It needs to even have the perception of independence, Mark. And be transparent. Completely transparent. And this has clearly not been the case. And this is one of the root problems why we have this epidemic of chronic disease and other medication that we have is because actually those people who should be doing better should know better. Those people in positions of power and influence are too close to industry. And I will not name this person. He's quite a well-known individual, but somebody very senior in the Department of Health in the UK. When I went to this person and said, I'm very concerned about scientific integrity, fraud in the research community in the UK, Too much influenced by industry, manipulation of data. You must be very popular over there.

Well, you know, Mark, I mean, popular.

Amongst two, at the end of the day, my job and duty is to do what is best for my patients. That's ultimately what we're here to do, isn't it? Totally. And he looked at me and he didn't look at me in the eye and he said, Asim, all I can tell you is the Department of Health is too close to industry. And that was enough for me to know what he was saying.

Yeah, no, it's true.

I remember speaking with a former Secretary of the US Department of Agriculture and Veneman, and I said to her, why are our dietary guidelines not matching the science? Why do we say that we should have three glasses of milk a day? Why are we not recommending the right kinds of fats? Why our Food Stamp program spends $85 billion a year for the poor that's serving mostly junk food and $7 billion a year just on soda or 20 $20 billion servings a year for the poor. Why do we have subsidies that support commodity crops that are turned into processed food that are consumed by Americans that make them sick and fat? She says, Mark, unfortunately, the industry has a lock on Congress and the White House. And I remember during the filming of Fed Up, Michelle Obama was filmed early on in the movie, coming out all guns blazing against the food industry and was excited and passionate and and then later on in the movie, she was filmed standing on stage with a lot of top food industry executives looking totally dejected and forlorn, announcing this great initiative to remove six trillion calories from the food supply, which sounded wonderful if you believe the calories are the problem. Turns out what they were doing was making an Oreo cookie 90 calories instead of 100 calories, which gives them more profit and us less sugar, but still is and that's the kind of thing we see. And it's, it's, it's frightening. And it's, and you'd see it across the halls of government. I mean, $500 million is spent just lobbying one bill, the farm bill, which is our major food bill in America. And that, is not transparent. And people don't understand why that's happening. And so you've got corrupt scientists, you've got corrupt public health organizations like the American Heart Association, which essentially gives hundreds of thousands, gets hundreds of thousands of dollars from the food industry for giving them their heart healthy seal. for things like Trix are for kids, which has seven teaspoons of sugar and all kinds of dyes and additives. I mean, how is, you know, a highly sugary cereal a heart healthy cereal? So that's crazy. 40 of the Academy of Nutrition and dietetics in America's budget is funded by the food industry. Pepsi, Coke, Nestle, all the big food companies. How can that be independent? So we have the government, we have scientists, we have public health organizations. We even have them usurping things in the community, using corporate social responsibility, like funding groups like the NAACP or Hispanic Federation, which is why they oppose soda taxes. So we have this really screwed up system where the industry is so heavy handed. How do we begin to sort of work to protect ourselves from that? You, you and this article laid out a whole series of initiatives and policies that you thought could make a difference. Can you talk a little bit about what we can do?

Cause it sounds kind of hopeless. I think there's a number of things we can do, Mark. In fact, on that note, one of our recommendations is we said that any organization, including, for example, the British Dietetic Association or the American Academy of Dietetics, if they take funding and sponsorship from food industry, they cannot claim their advice is independent. And we made that very strongly as one of our recommendations. We actually think- They should just put.

We're shill for the food industry.

Well, you know, Mark, I mean, that's one interpretation. Absolutely. I know, and people would think and in fact, actually, that also brings into, you know, I believe in democracy and very much, but, you know, if you ask most members of the public, do you think this is acceptable? If you tell them, do you really think most people would agree? No, they would find it quite extraordinary. They would be surprised, probably, and they would find it unacceptable that their dietary advice is coming, is being influenced by the very industry that wants to sell them food that is contributing to chronic disease. So I think it's about transparency, but ultimately, you know, the recommendations really concentrate from our paper on reducing sugar consumption through environmental change to regulation. So it's about getting, if we get the consumption of sugar down by at least 20% in the next few years, if we ban junk food advertising, essentially we reduce the consumption of processed carbohydrates significantly. We could very easily, if those were implemented, Mark, we could very easily reverse type 2 diabetes epidemic within three years. years. And on that note, when one looks at ultra-processed food, which is the major issue, there was a recent study published reporting in the Guardian newspaper in one of the nutrition journals that showed an association, a very strong association, between ultra-processed food consumption in European countries and prevalence of obesity. And the UK came at top, okay? And even I was shocked. The ultra-processed food consumption in the average British diet, 50% of the diet. Half of the diet is coming from ultra processed food.

Now, if you break that down- In.

America, it's almost 60%. Is it really? Wow. I mean, but if you break down the ultra processed food, where is it coming from? More than 70% is coming from starch, sugar, sugary drinks, ultra processed fruit and vegetables. Most of it is starch and sugar. It's not coming from saturated fat or fat or meat or dairy.

There are processed dairy and meat as well.

We were told to cut the fat and cut the meat. And we- the public health crisis we have is actually the big macronutrient, the big problem we're over consuming, which is the key component of ultra processed food, is starch and sugar. And this is what we need to get down. And that should be the public health message because we still hear, even in the UK, we need to get down the fat, sugar and salt. Why are we not discussing starch, ultra processed carbohydrates? Why are we not discussing that?

That is the big issue. Yeah. And you also talk about other initiatives like changing subsidies for commodity crops that get turned into processed food that artificially suppress the prices of the bad stuff and inflate the prices of the good stuff.

Yeah.

So, you know, we have to make it affordable, Mark. I think one of the things that's also very true is that actually some people believe that following a healthy diet, I think you can follow a healthy diet on a budget, but it's more difficult. A lot of the ultra processed foods are extremely cheap and the slightly healthy ones are more expensive. What we want to do is we need to shift that. And again, that will need government regulation so that we can make junk food more expensive and we know that will automatically across the population will change eating behavior. And even those small changes, but if it was across a population, would have impact on public health. And again, I always look at these from a point of view of, are there any harms from this for the public or for my patients, you know, as doctors first do no harm, there's no harm, it's only positive.

And you also talk about, you know, other initiatives that change the food environment that we live in because, you know, I had a patient once that said, you know, If I'm in this food environment, it's like an alcoholic living in a bar. It's hard to resist. So you talked about, for example, changing food advertising and banning advertising in sports events and getting celebrities to come out against junk food and soda instead of like Steph Curry and Tom Brady, who don't actually promote any of that junk, whereas others like the wine- They're setting.

A really good example. And this is what happened with tobacco. It's exactly the same thing. We can learn from that and do the same big sugar as the same.

Same.

We need, we know, you know, the reason there's advertising and association with sport, it's a branding opportunity for them, increases their sales. So it's very, and also there are certain things, you know, why are we allowing sporting events or the Olympic games? You know, I did a, I did a report for the BBC in 2012 as the angry cardiologist who said, we're in, we've got an obesity epidemic. Why are our main sponsors, the London Olympics, McDonald's, Coca-Cola, Heineken, Cadburys, you know? It's true. It doesn't make sense.

It's true. I had a friend who owns a basketball team and owns a stadium. And I said, why are you having these big jugs of Gatorade on the sidelines with the players? That's one bad for them and two, promoting some product that's mostly sugar and color and dye. He goes, well, we have to because we have contracts, but actually what's in there is not Gatorade. because the players won't drink it.

Wow. That's really interesting. Yeah. I mean, people need to know that.

It also changes the environment, how our supermarkets are structured, changing what's at the checkout counter, changing what the end caps of the aisles makes a difference in behavior, those behavioral economics and studies that have shown that.

We need political traction, Mark. And I think one of the things, the reason I went to the European Parliament, so this one of these members of European Parliament, Nathan Gill, who actually had type 1, type 1 diabetes and managed to reduce his insulin by 50%.

By going low carb.

But only 10 days ago, and this will be- It's low carb, higher fat. Absolutely, of course, because the protein doesn't really change much and you end up eating more fat for sure, under 100%. And, you know, I wrote a book on this, as you know, which- We talked about the Pioppi diet.

Everybody should get.

You know, which really tries to put, from my interpretation of all the evidence of where they've best components of food of the Mediterranean diet are and we need to reduce our starch and sugar and having really good effects and a lot of good feedback. But what was interesting is only 10 days ago, I got a phone call from the deputy leader of the Labour Party in the UK, Tom Watson, and the opposition party, he's a deputy leader. And he said to me essentially, he'd messaged me a few months ago and he said he'd lost 56 pounds effortlessly. from cutting out starch and glucose from his diet essentially. And he'd followed my diet plan. And I was like, wow, this is amazing. And he's sustaining it. And I think when the politicians in influence of power, they almost have an emotional, they emotionally wedded to this because it's helped them as well. I think that kind of thing ultimately will have an impact because these are the people ultimately that can really change things in terms of government. And when they know what's going on and they realize, I'm sure in their own minds that they've probably been misled because they probably didn't deliberately think you know, going to get addicted to sugar, all the effects it was having on them, and then they got better. I think they realized actually, you know what? Everybody should have this opportunity too, and what is our role as politicians to help improve the food environment? So I think it's a, these things are happening and I think they will happen. They have to.

How do you suggest fighting this view that it's going to create a nanny state where we lose our freedom, a free market?

Yeah.

So when people talk about freedom and so, you know, Markets function, first of all, I've got to say, Mark, markets function best on perfect information. So we're not actually practicing, the current system is far from the perfect market if people are not getting what they think they're getting. The payer and the transactor need to know exactly what they're getting. And if people are being misled, then there's something wrong with the regulation. I don't think society anyone would want to live in. And when you talk about nanny state, this is a term that's really used, in my view, is propaganda from people who want to to keep perpetuating the status quo where they're benefiting and profiting from regulations that are so weak that they can mislead people into buying their products that ultimately causes them harm. Let's just talk about what at the heart of the nanny state is about personal responsibility. Yeah, let's dig into that one. So to define personal responsibility, you need to have knowledge, the correct information, which you don't have if you're being misled to buy something that's high in sugar that's got the American Heart Association label on it. Okay, that's extremely misleading. That's not quite the right knowledge. And you need to have choice. And if sugar has become so prevalent.

That it becomes unavoidable, you don't have choice. And it's also biologically addictive, which makes.

Choice even more difficult. Once you get hooked, it's hard to get off. Absolutely. So, there's more reason for regulation. And actually, this 90-day argument doesn't stand up to evidence. Let's talk about evidence. The evidence tells us this doesn't stand up. This is nonsense. This is propaganda. People need to, these organizations need to be exposed. And if we don't do this, Mark, then really we are, we're in a big, we're already in a big mess in terms of chronic disease. Yeah, I mean, think about it.

Economically, we can't afford it. Think about cars, you know, we, we all drive cars. Why shouldn't we be able to drive cars without seatbelts and no airbags and, you know, no safety standards and poor.

Emissions because it's not good for society and it saves lives if we do those things. And those are all regulated. We don't call that a nanny state. No, we don't. And initially, when seatbelts were being brought in, the industry actually opposed it. The car industry opposed seat belts initially because obviously it was going to be more cost to them, more work, et cetera. And once they're in, same with smoking. I spoke to people who initially opposed the public smoking ban, but now realize it was a good thing. So those vested interests eventually- They had.

Airplanes and people lighting up on airplanes and they had a smoking section.

That was sort of a joke.

Absolutely. So I think as the awareness grows and people become more aware, then I think this nanny state argument will not stand up and the politicians will respond to the public. But the way the public get their information is also through the media in terms of getting it mass, mass media has a huge impact on public opinion. So we really need to engage journalists and editors as well to realize that actually these discussions need to be had. You can't keep this information from public.

Hey, YouTube, if you like this video, you're gonna love the next one.

Click on it to check it out today.

Inflammation, which is what I had, right? Widespread inflammation in my nerves, inflammation in my gut, inflammation in my brain, in my thigh. Exactly.

It doesn't qualify as a treatable disease.

Inflammation.

Right.

No, that's what I was joking. Say functional medicine doctors.