Interview - UltraWellness with Mark Hyman

You're listening to Optimize with Bryan Johnson. More wisdom in less time.

Well, I am thrilled to be with Mark Hyman today talking about all kinds of wisdom around functional medicine, ultra wellness, and how to optimize our lives. Mark, welcome. Thanks for taking the time.

Thanks for having me, Brian.

Well, let's jump straight in and I want to hear about functional medicine. You're one of the world's leading advocates and practitioners of functional medicine, and a lot of people aren't familiar yet with the beauty and the power of the model. Can you tell us about it?

Well, people go, what is functional medicine? Well, it's the opposite of dysfunctional medicine, which is what we have right now. And that's a model that treats symptoms, that uses medication, and surgery gets a priority, the body's functions. Functional medicine is a model that sees the body as an interconnected whole. It connects the dots. It looks at the underlying root causes of disease and helps to create balance in the system. So the body creates disease when there's an imbalance. And functional medicine is a roadmap. It's a way of thinking. It's a model for navigating so the landscape of illness and health. In a sense, it's really the science of creating health. And when we create health by getting the body in balance, disease goes away as a side effect. So that's the power of the model. I don't really treat diseases. I help create health. And as a side effect, the diseases go away.

So then walk me through the. And obviously I can imagine what the differences would be, but walk me through the primary differences between functional medicine and the traditional, often dysfunctional model that we use in Western society.

Yeah. So I'll give you an example. A little girl came to see me a while ago. She was 10 years old, and she had an autoimmune disease. It's called mixed connective tissue disease. And essentially everything was inflamed. She had inflamed skin, she had inflamed joints, she had inflamed liver, she had inflamed blood vessels. Everything was inflamed on her. And all her blood tests showed very abnormal markers of autoimmune disease. And the doctors were trying to get this girl comfortable to try to make her symptom free. And they gave her enormous doses of steroids, which is a drug that suppresses inflammation, and it can be a very useful drug in acute situations. But they were giving her intravenous doses of what we call Solunedrol, 1200 milligrams every three weeks just to try to calm her immune system down. It made her feel horrible. On top of that, they were giving her chemotherapy drugs which suppressed the immune system to try to shut off the inflammation. And it still wasn't working. So her mother brought her from Texas to see me. Her name was Isabel and she's always happy for me to tell her story. In fact, I could share a little video of her story that she recorded for me. But she came in miserable and I said, what is the cause of the inflammation? None of the doctors were asking the simple question was what's the cause? They were saying, what do we do to stop the inflammation? But they weren't saying what's the root of it? So we began to kind of sift through her story and look at the underlying causes. And we found that she had issues around gluten, that she had taken many years of antibiotics that changed the gut flora, that caused yeast overgrowth. We found that she loves sushi and, and made it into efficient. She was a little girl, which made her likely have mercury toxicity which can affect the immune system. So we found all these different things and we unloaded her system by eliminating the food sensitivities, by cleaning up her digestive system and getting rid of the bad bugs, by putting in good bugs and by giving her nutrients that she was deficient in, like fish oil and vitamin D, helping her body rebalance. And within six weeks she was dramatically better. Within a year she was off all of her medications and was completely symptom free and all of her lab tests had come back to normal. And there's no approach within conventional care that allow you to get there from here. So that's an example of somebody who had a condition that just isn't amenable to conventional care.

Please go ahead.

Another woman who was, who was a professor at Columbia University Medical School, who had diabetes herself, had had seven stents put in her heart because of angina and chest pain, who had severe depression, which diabetes causes depression such that she needed electric shock therapy to treat her depression and she couldn't lose weight. And she had many, many, many other problems. Cholesterol and so forth, high blood pressure, everything was out of control. She was on a pile of medications. She was a specialist in diabetes, which is hysterical. So she heard about my book, the Blood Sugar Solution. She came to see us at the practice Guilt for Wellness center and we put on a program to get her body healthy again. We took out the foods that were driving up her insulin. We took away the inflammatory triggers in her diet. We Got her on the right nutrients to optimize her cells functioning and communication, because there's ways of optimizing cellular responses to insulin, for example, and blood sugar through the right nutrients like chromium, magnesium, fish oil, et cetera. And we got her exercising a little bit and dramatically changed her way of life. And she was able to get off 100 units of insulin. She was on insulin. She was able to normalize her lab values. She was able to not be depressed for the first time in her life. She was also able to lift up her grandchild, who weighed 24 pounds, which she couldn't do before without getting chest pain. So she got her life back. And we see this over and over again. Some of the most vexing problems that we see today in our society because of our diet and our lifestyle and environmental toxins.

Yeah. That's amazing. So one of the key themes I'm hearing is a focus on. Traditional medicine has a focus on symptoms, whereas functional medicine is really looking at the root causes. It sounds so obvious when you say it.

That's right. Yeah. We treat the system, not the symptom. And the body is a system. It's a dynamic ecosystem. This is really ecosystem medicine.

Yup. That's awesome. Well, let's jump into again. There are so many things we can talk about, but let's go into diabetes. Your most recent book, the Blood Sugar Solution, talks about diabetes and diabecity, which I'm excited to hear your thoughts on. Can you tell us about the blood sugar solution, why we should care about it, whether we have diabetes or not?

Well, most of us probably have something. This is a problem that affects one out of every two Americans, either you or somebody you know or somebody you love. And 90% of the people who have this problem called diabesity, are not diagnosed. That's nine out of 10 people. It's a single biggest hidden health disaster that we're all facing. And it's this continuum of imbalances in your blood sugar and insulin that lead to belly fat. And then all the consequences of this belly fat, which is inflammation and abnormal cholesterol and high blood pressure and low testosterone and muscle wasting and inflammation and memory problems. Everything sort of happens as a consequence of diabetes. So we see people with heart attacks and strokes and dementia and cancer and depression and fertility, and we think these are all separate problems. So they may, in fact, be caused by what I call diabesity, which is this imbalance in your blood sugar and insulin. And it's a direct result of a mismatch between Our genes and our environment, we're adapted to being hunters and gatherers, eating wild food, wild plants, having no grains and having very little starch and sugar. Maybe we found a honeycomb or a patch of berries, but essentially low sugar. All of a sudden, the average American eats 150 pounds of sugar a year, almost half a pound a day. The Average teenager has 34. Teenage blood has 34 teaspoons of sugar a day. This is sort of unheralded in our biological history. And what's happened as a result is that we've switched on all these genes that create inflammation and obesity and diabetes, and it's really a foodborne illness. We ate ourselves into this problem. We got to eat ourselves out of it.

So how do we do that? So what are the primary tips that you recommend to get out of this problem? You just mentioned some of them, but can you talk about those a little more detail?

Yeah, you know, it's sort of how I recommend living for everybody. It's what I do. I kind of believe in the 9010 rule, which is, you know, 90% of time you sort of follow the principles that are creating health. And 10% of the time you can, you know, have that cake or cookies or, you know, drink a bottle of wine or whatever you know, you want to do to have fun. But your basic routine should be designed to create health. And for me, that's pretty simple. Like this morning I woke up and I had protein for breakfast. I had egg and avocado, a spinach omelet. For lunch I had some chili, which I'd made last night, which was actually with bison. I got some buffalo meat at the food store here and made spicy chili. And that was my lunch. I don't know what I'll have for dinner, but probably something not too dissimilar. And I have almonds on my desk. And I just create a routine where I don't have to think about food too much. I have my go to meals, I have my go to snacks. I know exactly where I'm going to be eating. I don't have any question about being in a food emergency. And I think many of us get into trouble because we get into food emergencies where we're hungry, we haven't planned, we haven't thought, and then we're going to go. Whatever, whatever's in front of us. If it's a vending machine, if it's McDonald's, if it's a soda, we're just going to not be able to fight that primitive urge to satisfy Our dropping blood sugar. So that's really important. Planning and thinking about your food and then figuring out how to hunt and gather in your environment, whether it's in your house, whether it's in your neighborhood. I know, for example, within a 10 mile radius of my house where all the food is. I need to get. I know where I need to shop. I know where I can get a quick snack. I know in my town where I can get lunch. I mean, I know what's on the menu in different places. I have an idea of how to never be in a food emergency. When I travel, I also have a routine. I bring that in my book. And I literally bought a suitcase. It was heavy, had all these canned salmon cans in it and nuts and wild berries. And I basically had to forage in my own suitcase because I knew that if I was in, like, you know, Des Moines, Iowa, I might not be able to find exactly what I wanted. You know, we had one show that we had lunch made for us. It was. It was, I think, luncheon meat. I don't even know what it was. American processed cheese on white bread with Doritos and Coke. And I was like, I can't really eat this and go on television for two hours. I think I'm gonna have to go find something else. I was like, okay. I know if there's an Asian restaurant close by, I'll probably be all right. They usually stir fry vegetables or something. It's like edible. So I said, is there a Chinese place around here? And they're like, yeah. So then I kind of went and foraged for the right meal, and I ended up being really lucky and got Chinese broccoli and tofu and grilled shrimp, and it was fantastic.

That's funny. Yeah, that's awesome. And then you mentioned no grain, so avoiding food emergencies. 90, 10. Got it. Fantastic. No grains, little starches, little sugar. Tell us about that.

I'm not an extremist. I definitely eat grains. I had some brown rice for lunch. I think that it depends on your biology for my patients, like this woman I was telling you about who was a type 2 diabetic on 100 units of insulin. Yeah, she's a no grains lady. No sugar lady. Because if you've gotten that far advanced, you need a little extra help. You know, Benjamin Franklin said, an ounce of prevention is worth a pound of cure. And many of my patients need a pound of cure. I, on the other hand, would like to just enjoy an ounce of prevention. I do have dark chocolate. I have some whole grains, but I think if you have metabolic issues and you are advanced in this process of diabesity and either have fairly advanced pre diabetes or type 2 diabetes, I do recommend people be at least short term on a reversal program where they reset their metabolism. But I think the key notion is eat real food. And Michael Poll has said it well, eat food, not too much. Most eat plants. Most of the food we're eating in our society is Franken food. 50% of the food that's eaten in America is processed junk food. About 30, 40% is. About a little more than 40%, I think is like meat and eggs and milk. And about 7% is like fruits and vegetables and whole grains and nuts and seeds. 7% is really what should be making up 90% of our diet. Yet it's making up 7%. So I'm sort of shifting more in that direction and it works. Protein for breakfast, lunch and dinner. It can be nuts, seeds, it can be plant proteins, it can be chicken, fish, animal protein. I try to a little more expensive, but I have less of it. But I have like wild buffalo and you can get grass fed meat. It's pretty increasingly accessible.

And then you mentioned 9 out of 10 people have what you've coined as diabesity and you quickly rattled off some of the markers of how we would know that. So diabetes, nine out of 10 of us. What?

No one out of two of us, out of those 50% who have it, only nine out of 10 know they have it.

Got it, got it, got it. Okay, thank you for clarifying that.

It's still a lot.

Yeah, yeah. So tell me more about that though, just so we can kind of identify those who might not be aware.

Yeah, yeah. So on my website, drhyman.com, i have a quiz called the Diabesity quiz and it'll tell you with a series of very few questions whether you have it or not. But they're questions like what's your waist circumference? Do you have a family history of obesity or type 2 diabetes? Do you have high blood pressure? Do you have sugar cravings? Is your triglyceride level high over 150 or is your HDL good cholesterol low under 40 for a man 50 or for a woman? Questions like these that help you identify either history points or lab test points that will guide you to understanding whether you have diabetes or not. And then in my book the Blood Sugar Solution, I have a more detailed questionnaire that goes through whether you have more basic mild case of this or whether you have a Severe case of this and then what to do about it.

Awesome. Okay, cool. So, Dr. Hyman.com, your book, the Blood Sugar Solution. Check it out. Great stuff. Let's move to ultramind, Another one of my favorite books of yours you talk about. Yeah, just an amazing, amazing perspective. And the subtitle to the UltraMind solution is the simple way to defeat depression, overcome anxiety, and sharpen your mind. Can you give us the quick overview of that?

Yeah. You know, it's a very simple idea that your body affects your mind. We've all been taught that the mind affects the body and psychosomatic illness is real. And that if you're stressed, it has a bad influence on your health. And we all sort of know that as a society, but very few of us recognize the fact that your body also affects your mind, that depression and dementia and ADD all can be caused by biological disturbances. It can be a low thyroid, it can be heavy metals, it can be a vitamin deficiency. You know, I would say it's a lot harder to get enlightened if you're B12 deficient than if you're not. You know, it's very hard to function if your brain isn't working because of some biological reason. So there are, of course, layers to happiness. There's your psychological state, your spiritual state. There's also your physical state. If your mind is encumbered by, by imbalances in your biology, then it's very difficult to be healthy. Like a woman, for example, who had severe depression, who was diabetic and needed electric shock therapy. Well, the diabetes and the blood sugar imbalances were what was causing her brain to not work. And when we fixed that, her depression went away. So I see this over and over again, and sometimes it's dramatic. Like, I've seen cases of autism recover. I've seen people with dementia recover. I've seen. I had a woman recently, she was in her mid-70s and she was on a whole bunch of boards. Very successful woman and had to retire from all that, couldn't function anymore, was very, very cognitively impaired, was diagnosed with pre dementia, was told she was going to go and have Alzheimer's, and there was nothing they could do. Well, I did some basic testing and she had a few little things wrong with her. She had a low thyroid that nobody picked up. And she had pretty severe B12 deficiency because as you get older, you don't absorb B12. And she also had a folate problem. Genetically, it was based on a gene that she had that wasn't able to Process folate. So I gave her high doses of folate and B12, special forms of them, and I gave her thyroid and tweaked her diet a little bit, and she just completely recovered. And then, like four years later, I got a call from her and said, Dr. Hyman, I need your help. I said, what's the matter? Well, I'm going trekking in the Himalayas, and I need to know what I need to bring and what I should do. So, you know, I was like, wow. You know, so I think we often assume there's problems that are irreversible, which are actually fixable.

Yeah. So again, we've got system, not the symptoms. Yes. We call that a good problem to have. What do I take to the Himalayas? Much better. Higher quality problem than deal with the other challenges. I was talking to Frank Lippman the other day about some of these ideas, and he mentioned that there's more serotonin produced in the gut than in our brains. It just blew me away.

Everybody talks about their gut feelings. I think that there really is a brain in your gut, and it's sort of an independent nervous system, and it communicates with your brain, but it's been called the second brain, and it has a huge effect on your energy and your mood. In fact, we used to think that people with irritable bowel syndrome, there's about 60 million of them, by the way, in America, including probably many people listening to this, that they really had psychological problems and that was causing their gut to malfunction, and they were stressed or anxious and neurotic. That was the problem. What we're learning is that changes in the bacterial environment and in the inflammation in your gut actually irritate the nervous system in your gut that then feeds back to your brain and makes your brain irritable. An irritable bowel is actually causing an irritable brain. It's not the other way around. By fixing the gut, you can actually fix the brain. Wow. Wow.

And again, all this is such part of a longer conversation, but mentioning inflammation a number of times. What are the key drivers of inflammation? If we were just looking at simple things that we're all doing in our lives. What are the primary things we're doing that's creating that high level of inflammation?

Well, people know that they have inflammation if they have a sore throat or if they get a rash or if they get some infected symptoms. Fingernail. Everybody's familiar with that inflammation. What I'm talking about is hidden inflammation. It's invisible. It's measurable. Through a blood test. And what causes and why that's important is that that inflammation has been found to be the root of almost every known chronic disease, whether it's heart attacks, strokes, cancers, dementia, depression, as well as the obvious things like allergies and autoimmune disease and so forth. So what's causing it is really important to know. And rather than just taking drugs to suppress it like aspirin or Advil, you want to find out what the cause is. And so for most people, it's diet, it's what they're eating. So there's really two categories. One is just processed and junk food and sugar, which are the biggest driver of inflammation in the country. And then the second category would be food sensitivities or allergies. And the most common ones are gluten and dairy. Those are huge. That's why many of my programs and books I have people get off of junk food and get off of gluten and dairy because many of their health problems will just go away. The second thing is environmental toxins. Big factor in triggering inflammation. Other things like being sedentary, just sitting on your butt doing nothing causes inflammation. Being nutritionally deficient causes inflammation. If you have low levels of omega 3 fats or other key nutrients that can trigger inflammation. Latent infections, things like Lyme disease or tick borne illnesses, chronic sinus infections, gut microbial problems, so abnormal gut flora, we do a lot of damage to our guts through what we eat or don't eat, through antibiotics, through pesticides. And so we can have abnormal gut flora. All these are triggers. Any kind of microbial imbalance can trigger inflammation in the body. Those are just a few of the top, top factors.

Right?

On stress. Yeah, stress is another big one.

Awesome. That's just, I mean, again, the 8020 on this, right? If we remove the process, the junk food, the sugar reduced, with the food allergies around the gluten and the dairy, then obviously looking at the obvious environmental toxins, it's just amazing what we can do with just those simple fundamentals, eh?

Absolutely.

Well, very cool. Your kind of underlying brand with what you do as ultra wellness. And we've talked about a lot of that kind of tangentially. But can you describe what ultra wellness means for you?

For me, it's really the concept of being able to wake up in the morning and feel alive and be able to do whatever it is that you love, Whether it's sitting in a rocking chair, reading a book or climbing a mountain in the Himalayas. You should be able to create A level of wellness and health that allows you to do that. What most people don't realize is that they're only a few days away from feeling really well. This is why I created my book, for example, the Ultra Simple Diet, which is a very healing dietary plan and lifestyle plan that people can do for seven days and then they can do a benchmark on what they feel before and after. It's amazing the changes that happen if you unload your life, if you, you sort of unjunct your life basically and detox your life and put in some good stuff and take out the bad stuff. It's an incredible thing to watch that people have this regenerative and healing capacity. It's like Dorothy and the wizard of Oz just clicked her ruby red slippers three times and you're back home in Kansas. It doesn't take a lot and I love to see this happen to people. And ultra wellness for me is that level of high level well being that allows you to feel healthy in body, mind and spirit.

That's awesome. And then I would love to hear about your fundamentals, kind of what you do, both the nutrition side of things, which we've talked about a little bit, and just other practices you might have in your life from exercise, meditation, et cetera that help you stay plugged in. That's a big part of this series is learning from extraordinary people and what you do on a day in and day out basis to really stay again plugged in and shining as brightly as you can.

Yeah, well, I have a very sort of specific set of things that I do that I've learned over the years that help me thrive. And really it's about thriving. And the first thing I do is I get enough sleep. So sleeping is critical and I try to get at least eight hours of good quality sleep every night. And I have all sleep ritual that I do before bed. Take a hot bath with Epsom salt and lavender. I let the lights down low, I'm out on my computer, I don't go check my emails, I don't check my phone. And I just sort of unwind in a way that lets the day sort of settle and gel and gets me unplugged from the high level stress that can happen during a day. The second thing is really key is food. And I'm very conscious of about what I eat, when I eat it and how I eat it. I start the day with protein, sometimes a protein shake, whole food protein shake. I have a lot of recipes for these in my books, or eggs and I Make sure I eat three meals a day and then I have a snack available if I'm hungry. And I keep my blood sugar very even. I've learned exactly how to do that. And if I keep my blood sugar even, I don't have any swings of energy. I don't have any swings and appetite. I don't have cravings and I feel good and I don't gain or lose weight. I also move. I love to move. So, for example, today I'm going to go cross country skiing. After we hang up, I'm going to go to yoga class tonight. So I take a half an hour in the day to go skiing and I'll go for a yoga class tonight after work. And I try to do something every day. Yesterday I played basketball, the day before or I went cross country skiing. I try to move in some way. I have fun and I usually play. I usually do it with somebody else. Take a hike and do something that's really enjoyable. And then I also take my basic supplements every day. My vitamins and multivitamin, fish oil, vitamin D and a few other things that I've learned. I eat over the years. And I make sure I take chunks of time out of my schedule to completely unplug. So periodically I'll take a week or longer if I can. I just came back from two weeks trekking in Bhutan, where I was completely unplugged from anything. Had no cell phone, computer, there was no electronics anywhere. All I had was my journal, a book on Buddhism, and my hiking boots and a backpack, and that was it. I was up in the mountains for two weeks. And that for me, a chance to reconnect and recharge and reestablish my own inner center and my values and just become clear. So I schedule that in the year as much as I can. I was an adventurer. I've been waiting 10 years, but you can do it in small ways for a weekend or anyway. So those are, for me, the things that are pretty critical. And also spending time with family and friends and community is really important to me.

Fantastic. Inspiring. Need to get those Epsom salts ready.

I love it.

Right on. Let's wrap this up with. I'd love to hear your number one tips for health and ultra wellness and then for life in general. They might be the same, but your number one tips for creating that optimal ultra wellness and creating a life that we're just really inspired about.

Well, I think those are some of the things I was just talking about about, which is eating real food, moving your body, connecting with those you love and building community and getting enough sleep and learning how to sort of take time out from all the sort of stress and struggles of life.

Yep. We'll wrap those into a little box and throw those handful of things into the number one. I love it. Any number one.

Just by the way, I don't have it perfect. It's a constant. It's a constant, you know, journey to toward hell. It's not, it's not a destination, it's a journey. So I'm constantly learning and tweaking and growing and falling off and getting back up and you know, I'm human like everybody else. So it's really, it's really essential for us to all sort of stay on track and have those reminders and places where we can come back to center.

Yeah, that's fantastic. Talbin Shahar, another one of my favorite teachers, describes it as a guiding star rather than a distant shore. We're never going to arrive at this place of perfection, but we have that compass to embrace and allow that dynamic flow. Well, Mark, I really appreciate you taking the time. So inspired by you and your wisdom and appreciate you. Thank you.

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