Inflammation: The Hidden Fire Behind Pain, Aging, and Disease

Mark Hyman, MD

Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Mark Hyman
But today our modern lifestyle is driving so much hidden inflammation, systemic chronic inflammation, silent inflammation. It's a silent killer.

It turns out that it's not the kind of inflammation that we are familiar with, like a sprained ankle or a sore throat or something that's an obvious kind of inflammation. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one on one, there just isn't enough time in the day. So I built several tools to help you take control of your health. If you're looking for guidance, education, and community, check out my private membership, the Hyman Hive, for live q and a's exclusive content and direct connection.

For real time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor trusted supplements and health products at doctorhyman.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast ad free with Hyman Plus. Just open Apple Podcasts and tap try free to start your seven day free trial.

Dr. George Papanicolaou
Twenty seven million Americans under over the age of 25 have osteoarthritis and the joint that is most commonly affected is the knee. It creates a great deal of morbidity, meaning that Suffering. Suffering.

Dr. Mark Hyman
Oh my god, that's a fancy metaphor for suffering, Right. Pain in the

Dr. George Papanicolaou
So yeah, so our traditional therapies basically help you control the symptoms but might not necessarily do anything to reverse it. So using Motrin or Atavil or Tylenol are common things people will use. And then your orthopedic surgeon may inject it with a steroid or they may use something like a lubricant. Like hyaluronic acid. Yeah, hyaluronic acid.

And so it's only a lubricant effect.

Dr. Mark Hyman
And you need a knee replacement.

Dr. George Papanicolaou
Right, and then getting towards a knee replacement, and then we know that forty percent of people that have their knee replaced still continue to have pain and loss of motion. So we don't have a lot of real successful treatments out there that are really changing people's lives.

Dr. Mark Hyman
Yeah, right, it's true. And I think, you know, we often used to think about osteoarthritis as a wear and tear problem. You know, you just beat up your joints too much. But it turns out it's really an inflammatory problem

Dr. George Papanicolaou
as Yeah, so what's interesting, it certainly increases with age and trauma to the knee is certainly part of what creates an inflammation. And that trauma can be repetitive use. It doesn't have to be an ACL tear from a football injury, it can just be repetitive use on a person who's carrying too much weight on their body. So obesity is a risk factor for arthritis.

Dr. Mark Hyman
But obesity also is a generally inflamed Right. So when you're obese, your fat cells are not just there holding up your pants, they're producing tons of inflammatory compounds that are making your whole system inflamed.

Dr. George Papanicolaou
Right. And so if you have an inflamed system and you're creating microtrauma to your joints, you're going to have an over reactive response in the joint. And joints, I think we should understand and know about them is that the cartilage and the ligamentous structures of the joint have lower oxygen tension than the rest of your body. Meaning that they don't have an enormous oxygen supply. It's a little bit different than the rest of the body and that plays a big role into why as we age that oxygen supply actually decreases, blood flow to those vital areas of the cartilage and ligaments decrease, so that when you injure them, they're less likely to repair, more likely to have an inflammatory response that leads to degeneration.

Dr. Mark Hyman
Yeah, interesting. So, what we're also learning about osteoarthritis, fascinating to me, was it when they're doing like biopsies and doing analysis, they're finding microbes in the joints. Yeah. Not infection, but just like dislocated microbes from the gut. So we're seeing the microbiome in in the the knee, which is crazy.

That's maybe also triggering an inflammatory Yeah, response,

Dr. George Papanicolaou
yeah. You know, we are really only 10% human. We understand because we have a 100,000,000,000,000 bacteria living in and on us, there are only 10,000,000,000,000 human cells, so

Dr. Mark Hyman
So conventional medicine, basically, your knee hurts, you go to the doctor, and you get an x-ray, and then you you have osteoarthritis, you take some Advil, you know, maybe do some strengthening exercises for your legs. Maybe if it gets really bad, you get a couple shots in your knee of steroids, that doesn't work anymore, you need a knee replacement. It's kind of a bad trajectory. There's no way to really sort of recover from this. And from a functional medicine perspective, we do a different approach.

Dr. George Papanicolaou
We do. And you know, we are gonna talk about that approach, but exercise does help, nutrition does help, losing weight does help. So there are definitely things that we can do with a person's lifestyle and help them intervene. I worked with a patient that was forty five pounds overweight, was eating a totally processed food diet, was drinking too much and was scheduled for knee replacement in September. I saw them in early July and I said, Hey look, if you do these things I'm about to tell you, I bet you, you could be playing golf in January in Miami with your friends instead of recovering from knee replacement.

And he said, Okay, I'll take you on. I said, Okay, if you win any money in Miami, I get 10%. All right? So guess what?

Dr. Mark Hyman
Did you get the 10%? He

Dr. George Papanicolaou
got what he wanted, I didn't get what I wanted. So he lost 45 pounds.

Dr. Mark Hyman
Amazing.

Dr. George Papanicolaou
I put him in physical therapy with a really good functional physical therapist, strengthened his knee, he canceled the knee replacement and came into an appointment, like walking, right? And he opened up an envelope with his tickets to Miami.

Dr. Mark Hyman
Aw. That's amazing. And so But just to be clear, it wasn't just like eat less, exercise more. No. You put them on an anti inflammatory diet, which is speaking to the point that osteoarthritis is not just a mechanical wear and tear breakdown, it's a chronic inflammatory

Dr. George Papanicolaou
Multiple things.

Dr. Mark Hyman
From functional medicine perspective, we deal with chronic inflammation holistically. So what are the things that you did diet wise and supplement wise that actually helped with his chronic inflammation that helped his knees and the weight loss?

Dr. George Papanicolaou
The really key thing was to get him to decrease his alcohol and also to decrease his intake of processed foods. These processed foods are fast carbs that go into your body, they have toxins in them, and they also create an inflammatory response driven by insulin.

Dr. Mark Hyman
So sugar and starch are inflammatory Right, and

Dr. George Papanicolaou
so we took that right out. So we just basically put them on a Mediterranean diet.

Dr. Mark Hyman
But not gluten and dairy free?

Dr. George Papanicolaou
Gluten and dairy, oh, absolutely gluten dairy free.

Dr. Mark Hyman
So why is that important?

Dr. George Papanicolaou
Because as we've talked about before multiple times, they're both inflammatory. And so gluten can actually trigger leaky gut, which again triggers that whole process of inflammation in the body. Then if you have any microtrauma to your knee, that inflammation, that cytokine response is going to lead to degeneration of cartilage and even bony structures in the knee.

Dr. Mark Hyman
So here's the deal, not everybody needs to be gluten dairy free. No. But if you were inflamed You gotta be. If you have a chronic problem, it's number one, two, and three on the list, right? Got a Gluten, dairy, sugar- Done.

And inflammatory foods as the first step. And then you say, Well, is it better? Is it not? Is it something else? Because it's sometimes something else, but it's really powerful when you put people on an anti inflammatory diet.

So Oh, if have osteoarthritis, diet is one, two, and three, and it's really getting on a whole foods, plant rich, good fats. Absolutely. Like lots of anti inflammatory foods, getting off gluten, bravish, Yeah,

Dr. George Papanicolaou
and starch, processed you put them on really good healthy fats, because fats are a really important part of the anti inflammatory process. I put them actually one of my favorite things to do when I'm dealing with inflammation is high dose omega-3s.

Dr. Mark Hyman
So lots of omega-3s, So

Dr. George Papanicolaou
I use four thousand or more, So I put them on omega-3s. I use an anti inflammatory botanical called curcumin. So sort of like a botanical Advil. So I put them on that. I also use something like it's a supercharged omega-three, it's refined from omega-three, it's called specialized pro resolving factors Mediators.

And they are very SPMs. So they're very potent anti inflammatories. So between his

Dr. Mark Hyman
diet It's sort like the it's not like taking all the the good juju out of the omega threes Right. And concentrating them. And there's a lot of research done at Harvard on this.

Dr. George Papanicolaou
Oh,

Dr. Mark Hyman
yeah. And you your body has this ability to resolve inflammation. It has an auto built in system. Right. It's called resolvents.

So resolvents are molecules in your body that resolve inflammation. So these are called specific proresolving So they're really effective. They are. There's lot of research on these. And a

Dr. George Papanicolaou
lot of research particularly post surgical recovery, post trauma recovery, that these will actually enhance recovery and you'll have a shorter recovery time when you're using SPMs.

Dr. Mark Hyman
Yeah. So they can be very effective. So diet, supplements, and Targeted supplements. Yeah. Even vitamin D might be helpful because it strengthens Oh yeah, bones and absolutely.

Right?

Dr. George Papanicolaou
Yeah, vitamin D and omegas are pretty much standard for me when I'm dealing with anybody with any amount of inflammation because of the impact that vitamin D has on the immune system, inflammatory system, mood. It just does so many things. In addition, physical therapy is very important because we do know that the muscular strength around the joint will protect that joint and keep it from the constant damage that it can get from repetitive use.

Dr. Mark Hyman
I So just never had any knee problems, knock wood. Yeah. But I have very big thighs because I was a runner most of my life and biker, so I have like really big thighs and my knees, my leg thighs are strong because my knees always were protected.

Dr. George Papanicolaou
Right. Yeah. So I can tell a personal story. I had my right hip replaced, I had no pain. And then I fell, I injured it, it got inflamed, and within four months I had to get a hip replacement.

And I asked the surgeon, why did I have end stage arthritis and not know it? Well I had been running and I had been racing a bike for ten years. I mean I had really strong legs. And he said there are couple things George. One is you have so much strength in the leg and you may have been a person, because of your diet you're not very inflamed.

So your cytokine response at the joint limited the pain you were gonna feel. So strength and anti inflammatory living can actually keep you from even knowing you have arthritis.

Dr. Mark Hyman
It's amazing. I had a lecture I did recently, and there was this woman who's like, I did your ten day reset. Basically, it's an anti inflammatory detox from sugar and starch, and gluten dairy and sugar. It's a really nice program, you can go to getpharmacywithanf,get,pharmacywithanf.com, and you can learn about it. You can download the program free.

You can get the extra version if you want. But she did this not seeing me as a patient, just on her own. She said, I was scheduled for a bilateral knee replacement. I did this program and I needed it for more than ten days, obviously. And I canceled them because my knees are fine now, which is a pretty amazing story.

I've heard this over and over. Yeah. So I think if you're facing that level of surgery, I mean, a knee replacement is not easy. Hip replacement, you get the hip, you're up and going pretty quick. Knee replacement, you're out for a long time, a lot of hard work, physical therapy, you don't really get back to perfect.

I mean, can be great for But people who need there's some other intermediate steps before you get there, even if you know your diet's great and everything's great, you've done all these things and it's still not working, there's another therapy that has merged that is really

Dr. George Papanicolaou
powerful Yeah, is very powerful stuff. I wanted to make sure we talked about the lifestyle and this important thing. Yes. But what we really wanted to talk about was ozone and prolozone, and what it can do for the joints.

Dr. Mark Hyman
Now people take us through this because most people hear ozone, think the ozone layer and it's bad for you and what?

Dr. George Papanicolaou
Right. So ozone is a gas. We know that there's oxygen and oxygen is actually two oxygen atoms that come together and they have to be together because they're very stable together. Oxygen by itself, it needs another electron so it shares it with a partner. So you have O two, they're married and they're very happy together.

But if they get any solar activity placed upon them or any electrical activity, they'll split. And that's happening constantly all the time. But they'll come back very quickly together. But sometimes they come back and there's a third person there. Right?

There's another extra oxygen molecule that's latched on because you couldn't find a partner. So now you have this what we call triatomic oxygen or O three. And now there's not enough electrons for all three to share. So the two oxygens, I gotta find a way to get rid of this third wheel. So that becomes a very unstable molecule.

And it's that very thing that makes it so effective. Us how

Dr. Mark Hyman
it works. So how would you use that with arthritis?

Dr. George Papanicolaou
So the way it works is that we can actually, we have an ozone machine, we have a machine.

Dr. Mark Hyman
Ozone generator. Which takes oxygen and runs it

Dr. George Papanicolaou
through the

Dr. Mark Hyman
machine that was invented by Nikolay Tesla.

Dr. George Papanicolaou
Oh, I was just he did it again.

Dr. Mark Hyman
Stole I did say something It too, it's was my podcast. So Nikola Tesla

Dr. George Papanicolaou
in 1890, think it was like 1893 or so, he patented the first ozone machine, which is a really cool thing. So now we have ozone machines and we have an ozone machine that we hook up to medical grade oxygen and in that machine it will take that oxygen, it will hit it with electricity and create ozone and it can be modulated as to how much ozone you can actually make. And you make anywhere from one to 5% oxygen ozone mixture in different concentrations and we can adjust that concentration. We picked it So it's

Dr. Mark Hyman
mostly oxygen with little ozone.

Dr. George Papanicolaou
Yeah, mostly oxygen with a little ozone. And that's really critical because part of the it's ozone, it's oxygen ozone therapy. Because part of the benefit comes from getting oxygen into the joint. And then the ozone plays another role. So we then take this ozone and we inject it directly into the joint.

It can be the shoulder joint, it can be the knee, it can be the hip, it can be the ankle. Any joint you can put ozone in. The way ozone works is pretty interesting. Because it's unstable, it actually has what we call a hermetic effect. It actually, by the fact that it stimulates the body to do something better by irritating it.

Dr. Mark Hyman
It's a little Like you're lifting weights, tear some muscles and

Dr. George Papanicolaou
you get bigger, stronger muscles. Right. So what happens inside the joint is that it will actually modulate the cytokine response. So when you have that damage to your knee and you're constantly moving it, you're constantly creating that inflammatory response. And there are cytokines.

And those cytokines will then, this inflammation will lead to the breakdown of cartilage and eventually even bone and it also mediates pain. Ozone has been shown to modulate that response so that it will actually produce more of the anti inflammatory cytokines versus the pro inflammatory cytokines.

Dr. Mark Hyman
So that's It also activates your antioxidant system. It's like an antioxidant for your knee and anti inflammatory directly in there.

Dr. George Papanicolaou
Exactly. So you get anti inflammatory, it stimulates antioxidant, an antioxidant effect, but remember what I said earlier that the knee and the cartilage anywhere and ligamentous structures don't have a great oxygen supply. And when you have that much inflammation in an older person and that oxygen supply and circulation has been diminished, now you don't have any of the healing capacity that you would have had without inflammation or if you were younger. What does ozone do? Ozone actually increases blood flow, it increases oxygen delivery and oxygen utilization.

Dr. Mark Hyman
Wow, And that's

Dr. George Papanicolaou
it stimulates chondroblast and fibroblastic activity so that you can actually build up cartilage and build up the soft tissues around the knee. It's pretty amazing

Dr. Mark Hyman
I'm just gonna tell a personal anecdote. So I've also been trained in ozone, and we do this here at the Ultra Wellness Center, Prolose and other forms of ozone therapy for chronic illness, are really effective for so many things, and definitely on the margins of medicine, but very, very powerful. And I had a broken arm a number of years ago, and went to get training on how to do this, and my arm wasn't healing. And then I had a frozen shoulder. Could I not move my arm above 45 degrees from my body.

It was so painful. He's like, Yeah, I can inject your shoulder, the guy who was training us. He took ozone and injected it into my shoulder joint, And literally within five minutes, I was like doing this. I was completely mobile, moved my arm everywhere. There was another doctor in the training as well who had had a frozen shoulder, not just for six months, but for years.

Same thing injected his shoulder. Yeah. Wow. It's a miracle.

Dr. George Papanicolaou
Seen it over and over again. Yeah. It's amazing. And I

Dr. Mark Hyman
remember a patient, not that was mine, but when I was in training, there was a guy who had been an NHL hockey player, and he'd won five Stanley Cups, part of the New York Islanders, and his knees were shot. He couldn't walk. And he'd come in for a number of treatments with his doctor, and after the ozone treatments in his knee, which I saw him administer, he just literally was up and walking. And I've seen people come in with canes and dance their way out. It's pretty amazing.

Dr. George Papanicolaou
I know it sounds, you know

Dr. Mark Hyman
It sounds wacky, right?

Dr. George Papanicolaou
It sensational, but it is.

Dr. Mark Hyman
I mean, convinced me. Literally could not move. Know I had to go to physical therapy for a year and had to maybe go under anesthesia to mobilize my shoulder and all these things I was getting recommended. I'm like, it was like five minutes and it was painless.

Dr. George Papanicolaou
Yeah, it is.

Dr. Mark Hyman
It was a little needle poke but that Yeah, was

Dr. George Papanicolaou
and when we do it, we not only inject the ozone in but because we know what's happening and the joint hasn't been getting the blood supply it needs, the nutrients it needs, we'll add in some nutrients that are part of the healing process. So we'll add in some methylcobalamin, some magnesium and procaine. We use procaine also because it actually changes the action potential of the cell and membrane which has been disrupted by the inflammation and it allows for the cells to become healthier. So the procaine actually is not just for the anesthesia but it's also to help the cells heal.

Dr. Mark Hyman
That's amazing. So tell us about this patient you had who you treated with ozone here at the Ultra Wellness Center using Prolozone, which is a form of ozone that you inject into joints or soft tissues to help with pain.

Dr. George Papanicolaou
Yeah. So this is a woman who just two years ago went on a pilgrimage and hiked through these very high mountains in Spain. And on that hike, had been having pain in her knee on and off, but nothing had ever inhibited her from doing anything she wanted. But on this hike, suddenly it blew up and she couldn't finish her pilgrimage. So she came home to her doctor, x rays were done, and she had pretty much bone on bone in her knee.

Dr. Mark Hyman
Wow.

Dr. George Papanicolaou
And so over the past two years, she has had steroid injections and she's had a lubricant injection with hyaluronic acid and she had some benefit but she still wasn't able to hike. So she asked if I would treat her and I evaluated her and I treated her with ozone. And after her second injection, just three days ago, we had her second injection almost two and a half weeks ago, three days ago she went on her first hike in two years. She hiked six miles.

Dr. Mark Hyman
Wow.

Dr. George Papanicolaou
And went over mountains that were very high and she didn't have a problem. And the day after she said, I didn't have any swelling.

Dr. Mark Hyman
That's amazing. That is amazing. And so how many treatments do people often need? Doesn't sound like that Usually,

Dr. George Papanicolaou
I tell people between three to maybe eight injections, usually somewhere between three and six is the sweet spot.

Dr. Mark Hyman
And then can come in for a tune up if you need it. Absolutely. Is it painful?

Dr. George Papanicolaou
Not at all, not at all. I mean you'll feel the needle going in initially but once I'm in the joint it's not painful, you may feel the pressure of the ozone going in, but I monitor that very closely when I'm doing it and I can actually feel it.

Dr. Mark Hyman
You can feel the belly fill up with gas.

Dr. George Papanicolaou
Yeah, you can.

Dr. Mark Hyman
And it's basically a disinfectant, so there's microbes in there that shouldn't be Gone. It activates the anti inflammatory system. A powerful antioxidant.

Dr. George Papanicolaou
It manages the cytokine response, which causes the inflammation and the pain.

Dr. Mark Hyman
It's pretty remarkable. If I hadn't experienced it myself like that, would like, Oh, this sounds really quacky. Actually, a real procedure that's being used all over the world for years. Years. Years.

It's used here to some degree, but in many other countries like Cuba and South America and- Spain, Italy. Russia. Mean, they're doing this It's extremely inexpensive. It's super effective. It's probably more effective than most traditional treatments for osteoarthritis.

Dr. George Papanicolaou
Absolutely.

Dr. Mark Hyman
And it's got very low downside and very low cost. When you inject steroids in a knee over time, it's gonna degrade the cartilage, it's gonna degrade the knee, it's gonna make things worse. Right. You get a temporary benefit, but then you end up with worse symptoms.

Dr. George Papanicolaou
Ten percent

Dr. Mark Hyman
of restore the people cartilage.

Dr. George Papanicolaou
That study that came out in 2019, ten percent of the people that get steroid injections, actually their arthritis gets worse. Yes. And they end up with unexplained fractures.

Dr. Mark Hyman
Yes. Because it weakens their tissues.

Dr. George Papanicolaou
So we know that.

Dr. Mark Hyman
And with prolozoma, we've cartilage regenerate.

Dr. George Papanicolaou
Right, and that's the difference. I wanted to make sure we made that point because it stimulates chondroblasts. Chondroblasts are the cells that rebuild cartilage. It can rebuild the cartilage and again, what we love in functional medicine is to find those modalities that just don't maintain disease, but will actually reverse it, and Prolozone fits the bill.

Dr. Mark Hyman
You were saying this patient, she's hiked six miles, and she was told she needed knee replacement.

Dr. George Papanicolaou
Yep. Yeah, I'm telling you, it's pretty amazing. She's pretty near bone on bone. That's incredible. Well, it'd

Dr. Mark Hyman
be interesting to see her follow-up x Yeah,

Dr. George Papanicolaou
I'm interested. And

Dr. Mark Hyman
to continue to do this and track it, but I think people out there suffering from osteoarthritis, the focus really should be on lifestyle. And I think people need to understand they have a lot of power to transform the inflammatory state of their body. And what often is considered diseases of aging are often inflammatory disease. We call it inflammaging. Yeah.

I think the arthritis is part of that. It's not just a bone on bone, you know, mechanical issue. It's an inflammatory issue. What are the causes and drivers of inflammation? Well, basically number one, two, and three is diet.

And guess what? The number one, two, three in diet thing is sugar, sugar, sugar, or the equivalent of sugar, starch, starch, starch. So anything that's sugar and starch drives inflammation, particularly high fructose corn syrup. So that should not be a staple in your diet. Unfortunately, is about 60% of our calories in America.

Soda is the number one source of calories in America, which is terrifying to me. And the average American eats 152 pounds of sugar and 133 pounds of flour every year. That's enough to kill, you know, most of us pretty quickly. And it does. Which is why we see we're the sickest population in the world and so many people die from diet related diseases.

So it's in sugar, it's in high fructose corn syrup, it's in processed flours and foods. Also inflammatory fats may be a factor. So lots of refined oils, non F omega threes, trans fat, which have been ruled not safe to eat by the government, but they're still everywhere in food. I don't know how that works to be honest with you. I guess there's little loopholes that the food industry gets to give them maybe years or decades, but this was February ago.

They say, hey guys, trans fat kills you, not safe to eat, don't use it. But if you go to the grocery store, you can find it everywhere, which is terrifying. I mean, more and more companies are removing it, but it's still there. Also, what else can cause low grade inflammation? Sitting on your butt.

Not exercising. Exercise is a powerful anti inflammatory. Not over exercising, running a marathon, but doing a moderate amount of exercise every day really helps lower inflammation. Stress, another big cause of inflammation. So nothing we knew about stress, it's out there.

Bad things happen. Reading the news. I try to stay away from the news, by the way. It's so stressful. Like, I figured if something really bad is happening, I'll I'll hear about it.

But but the key is to find habits and behaviors that reduce your stress response. Meditation, yoga, you know, hot and cold therapies, massage, breathe, breath work, whatever whatever works for you, try it. But it's gotta be a daily practice. I do it every day. Today, I worked out, I did a sauna and a ice bath, and that really helped me calm my nervous system.

I also deal with toxins. Toxins are also inflammatory. They're called immunotoxins. Low levels, pesticides, chemicals, petrochemicals, heavy metals. I encourage you to go to the environmental working groups website, EWG, and find how to reduce your exposure through food, including fruits and vegetables, animal products, fish, household cleaning products, and even skincare products.

I mean, did you know the lead is in a lot of lipsticks? That a lot of skincare products have petrochemicals that get absorbed through your skin and get in your body and cause harm? Yeah, don't be doing that. So, also another source sometimes is, latent infections. We might not know we have it like a virus or, tick infection or mold we're exposed to.

So those all can drive inflammation. And of course, our microbiome is probably one of the biggest sources of inflammation in us. We all have an imbalanced microbiome, mostly from our poor diet, lack of fiber, processed food. So we want to cultivate our inner garden. I've written a lot about this.

We've created a new product called gut food that helps people actually heal their gut and and it's like a multivitamin for the gut. So I encourage you to check it out, gutfood.com. So really tending your inner garden is so important because there's actually a phenomena called metabolic endotoxemia. This is a phenomena that is resulting from bad bugs that produce these toxic compounds called endotoxins that get absorbed through your gut lining into your bloodstream and then activate your immune system. Like for example, these lipopolysaccharides, which are these little endotoxins, and then your immune system gets activated, triggers inflammation, and there's all the downstream causes consequences of that.

For example, high levels of TNF alpha, one of the inflammatory molecules, and it triggers insulin resistance. So literally not even by changing your diet, you can become pre diabetic just by the toxic bacteria in your gut. That's why they call it metabolic endotoxemia. So what is inflammation? What's the big deal?

Why does it become so dangerous? Well, inflammation is a natural part of your body's function. It's essential. Yes, you cut yourself. What happens?

The white blood cells gather. They come to the site to rescue. They create swelling. They bring all kinds of healing factors. And what you see is redness and swelling and pain and heat.

That is the classic sign of inflammation in the body. We used to call that medical school rubor, dolor, corlorn tumor. Tumor just means swelling, not tumor, you know, it's anyway, Latin, whatever. But the key is that it's this normal process that happens as a result of dealing with problems that go wrong. But here's the rough.

In the past, most of what we had to deal with was acute things that cause inflammation, like a cut or an infection. But today, our modern lifestyle is driving so much hidden inflammation, systemic chronic inflammation, silent inflammation. It's a silent killer. It turns out that it's not the kind of inflammation that we are familiar with, like a sprained ankle or a sore throat or something that's an obvious kind of inflammation. The kind that's good.

The kind that's we're talking about is the kind that's bad. And that leads to almost every known disease of aging, heart disease, cancer, diabetes, Alzheimer's. Not to mention things like ADD, depression, obviously autoimmune disease, obviously allergies, asthma, all sorts of gut issues. All of these problems are caused by inflammation. Of course, then the question is what causes inflammation?

We're gonna get to that. From a functional medicine perspective, I don't care that you're inflamed. Care about why you're inflamed. I don't want to give you an immune suppressant, an anti inflammatory drug, a pile of aspirin. I want to find out what the causes and get rid of it.

In functional medicine, there's a simple rule and it's this, it's called the TAC rule. If you're standing on a TAC, it takes a lot of aspirin to make it feel better. Take out the TAC and if you're standing on two TACs, taking one out doesn't make you 50% better, so get rid of both of them, Okay? And all of them, maybe there's five or 10 tacks and that's the secret of functional medicine. It's a method of investigating the body as a system, looking for root causes and getting the body back in balance.

All right, so what is the deal with this inflammation? I mean, I think, you know, when I was in medical school, heart disease was a plumbing problem. You know, it was clogged arteries. We now know that it's an inflammation problem. That the reason your cholesterol becomes an issue is because it gets inflamed and white blood cells stop up soup, stop up the cholesterol and stick it in the arteries causing plaque.

Same thing happens in the brain. Alzheimer's is inflammation in the brain. All those plaques, the brain come from inflammation. So cancer also is a disease of inflammation. And when you forget to look at various studies, even with cholesterol, if your inflammation level is high, but your cholesterol is also high, you're at high risk.

But if your cholesterol is normal and your inflammation's normal, you're no risk. But if your cholesterol is high and your inflammation is not high, you're really not great risk. The worst is if you have obviously both. So inflammation is a real big issue. They did a study of an elderly population, they found that if their CRP was high, which was a blood test for inflammation and interleukin six and other cytokine tests for inflammation, they had a two sixty percent more likely chance of dying in the next four years.

So this is no joke. So you might feel fine. I had a patient with me, he's like, I don't know what's wrong. I feel fine. I don't.

I saw my blood test says I don't really care. I feel fine. Why should I change what I'm doing? I'm like, well, if you don't change what you're doing, it might not go well for you. Now, there's no guarantees that's true, but it's likely true.

So the real concern isn't our response to an injury or an acute infection or something like that, but this chronic smoldering inflammation that slowly destroys our organs and our ability to function and leads to rapid aging. In fact, I just finished my book on aging called young forever, And they talk about the hallmarks of aging. One of the key hallmarks is inflammation, or they call it aging itself, inflammation. And what happens with aging is there's this runaway inflammation that just degrades your whole body. So understanding what inflammation is, how to diagnose it and how to deal with it and get rid of it is so essential if you want to be healthy.

Now, what's the problem with the treatments we use? Why not just take Advil or aspirin or take a steroid like prednisone? Well, they're fine for acute problems, but when things are in this slow smoldering state, they really don't work. In fact, the new data on aspirin was pretty scary about heart disease. Oh, it's going to help you and stabilize your blood, blah, blah, prevent clotting, but it turns out that the recommendations for aspirin were over enthusiastic and that there are certain patients who should be on aspirin, but very few compared to the universal statement that everybody should take an aspirin to prevent heart disease, no, because it causes strokes and it causes bleeding, which is not good, like GI bleeding.

So, you know, if you look at those drugs like aspirin or Advil or Aleve, they're not benign. I mean, they, they really helpful when you need them, but they can cause terrible gut issues. I had gastritis, for example, after taking them for a broken arm and many, many people die. In fact, many, as many people die from taking those drugs as from asthma or leukemia. So imagine if we literally eliminate those drugs, we'd basically be essential.

It'd be the equivalent of curing leukemia or asthma. So it's not a joke. So know, statins for example, even cholesterol drugs like status like Lipitor, they may not have their main effect by lowering cholesterol. In fact, it may be because they actually lower inflammation. That's what they do.

It's a side, quite a side effect of the statin, actually may be their main effect. So how do you know if you have inflammation? Is there a way to test for it? Is there a blood test? Well, there are and there are more and more coming.

So the most common one that people do is called C reactive protein. It's high sensitivity C reactive protein. It's your, to me your doctor can order, it's on any lab panel you can get. And you can also see that as a sign of hidden inflammation. Now if it's super high, it could be infection.

But if it's in the sort of one to 10 range, that's usually the hidden inflammation. There, there ideally it should be less than one. Any higher than that means you're on your way. Now there are other blood tests you can check cytokines, sed rate and so forth may not be as helpful, but there's a new test by, developed by a professor at Stanford called IAGE, I A G E, meaning immune age. And it really looks at your immuno, which are 50 different cytokines, many of which you've never heard of.

They're molecules that are regulating immunity inflammation that he was able to correlate by using artificial intelligence with disease. So he found there really, there were about four that highly correlated with your risk of heart attack, cancer, diabetes, Alzheimer's, so forth. What's so amazing is this test is really not that expensive. It's easy to get and you can track it over time. And then the good news is you can change things and change your inflammation.

Anyway, enough with that. So, you know, the reason we really don't track this is because doctors just kinda are not thinking about the root causes of disease. They're like, okay, what's your symptom? What are you suffering from? Okay, let me find the drug that best matches that.

You If you have a strep throat and I can give you penicillin, great, I'll get a cure. But most of time I'm just managing symptoms or I'm giving you an immune suppressant and that's not the answer, unfortunately. So, okay, so let's say you've identified the causes, you figured out you have inflammation, you know, how do you live an anti inflammatory lifestyle? It's the same old stuff, I hate to say it, but it's eat real food, lots of phytochemicals, all those colorful plant compounds are anti inflammatory. All the the phytochemicals in food are so powerful for reducing inflammation.

Also, you know, just real whole unrefined, unprocessed foods, not lots of sugar and starch, not no trans fats, no no refined oils, and get lots of those phytonutrients. Good fats are really important too. Avocados, olive oil, extra virgin olive oil ideally, omega-three fats, things like sardines, herring, sable, wild salmon, they're all really rich in omega-three fats and they're very healthy for you. Exercise. Lots of research on exercise can reduce inflammation, supports your immune system, it strengthens your heart, it corrects insulin resistance, and improves your mood, helps reduce stress.

I mean, it's one of those miracle therapies that can really do so much for you at so many levels. Practice active relaxation, which sounds like a contradiction or an oxymoron, but no, you have to actively relax. It's not, I don't mean sitting watching TV, drinking a beer. I mean, meditating, doing yoga, deep breathing, getting massage, doing something where your body just kinda hits down into the parasympathetic state and calms your nervous system. Hot bath, I love that.

Last night I was little, had a very busy day, lots going on, and I just took a hot bath with Epsom salt, and I just kinda floated away, it was great. Also food sensitivities are another big factor, you might not know this, but a lot of hidden inflammation come from not allergies, but food sensitivities, things like gluten, dairy, and certain things that people react to that they may not know they react to. So I often recommend an elimination diet, like the ten day detox diet that I created to help people reduce their overall level of inflammation, and then you can add back foods and see what's really the problem. So maybe eliminate a lot of things and then you just add back one at a time and for example, dairy I know cause inflammation, if I have dairy, I get pimples, my skin's weird, I get congestion, so I don't eat dairy. Although I do manage to tolerate goat and sheep okay.

Healing your gut, you know, doing a gut repair program, that's why we've created gut food that's so important. I think many people would benefit from actually focused gut repair program because a lot of their imbalanced bacteria are causing inflammation. And And lastly, take the right supplements. A multivitamin, fish oil, vitamin D, help drop inflammation. Well, what are the things in your mind that you go through as a checklist if someone comes in with an autoimmune disease?

Dr. Cindy Geyer
Well, the first step I'm going to go is looking for celiac disease and gluten sensitivity. Mean, that is a do not miss in 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 Cindy Baker's TAC rules. If you're trying to control the autoimmune condition, but you're sitting on that gluten TAC, it's gonna be really hard to quiet everything down and feel good.

You have to remove the driver of the inflammation and the autoimmune upregulations. That is the first place that I go.

Dr. Mark Hyman
Before you go on from that, I want you to explain the rest. I But just wanna emphasize that because, you know, when someone comes with an autoimmune disease, getting a celiac panel is like checking a blood pressure. It's just the most basic thing you can do. And often people misinterpret it because the levels are, quote, 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.

Dr. Cindy Geyer
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. 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.

Dr. Mark Hyman
Absolutely. Yeah. Absolutely.

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

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

Dr. Cindy Geyer
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 to, ah, 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 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.

Dr. Mark Hyman
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 autoimmune disease?

Dr. Cindy Geyer
Well, 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 I won't say that stress per se necessarily causes an autoimmune condition, but it can certainly perpetuate the cycle of inflammation.

Dr. Mark Hyman
Makes it worse, for sure.

Dr. Cindy Geyer
Makes it worse, Just like sleep deprivation, the same thing.

Dr. Mark Hyman
Doctor. Yeah. So toxins, like you said, are actually immunogenic and that there's a word for the role of toxins in autoimmune disease. They're called autogens. They literally cause an autoimmune response in the body, whether it's pesticides, heavy metals.

And I've seen this, and I'm sure you have seen it many times in your practice. And you never know if it's that. Or so because 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

Dr. Cindy Geyer
the right

Dr. Mark Hyman
infections because we often ignore those. The body's 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.

That's what kills you. And in autoimmune disease, I think there's an unrecognized role of infectious disease. There is some literature about this for sure.

Dr. Cindy Geyer
Absolutely.

Dr. Mark Hyman
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, all the data on autoimmune disease, you can type in autoimmune toxins and diet and gluten and allergens and and Lyme disease. You can do have you you can and you'll find all these papers. But what's striking to me is 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.

Dr. Cindy Geyer
Know, Mark, it's interesting. When we were in medical school way back in the day, we learned about Reiter's syndrome, right? Reiter's 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 genitourinary infection like chlamydia. So we knew even thirty years ago that those infections can actually trigger an autoimmune reaction.

Dr. Mark Hyman
That's right.

Dr. Cindy Geyer
And more recently, there's been a link with porphyromonas gingivalis, so an oral bacteria and rheumatoid arthritis.

Dr. Mark Hyman
Yes. Absolutely. Can also be a source, right?

Dr. Cindy Geyer
Doctor. Yep. Of course, I didn't mention. So absolutely.

Dr. Mark Hyman
So so someone comes with Raynaud's, 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 figure 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 Raynaud's. How common is this problem?

What are the symptoms? What is the general approach with traditional medicine?

Dr. Cindy Geyer
So you talked a little bit about the symptoms, that it's typically fingers, sometimes toes, sometimes nose turning white or blue 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's two primary there are two types of Raynaud's. There's primary Raynaud's, which supposedly is just the Raynaud's by itself. And then there's secondary Raynaud's, which is associated with autoimmune conditions like rheumatoid arthritis and progressive systemic sclerosis.

And the second component tends to be more severe. It can even lead to ulcers on the tips of the fingers and things. It's more common in women. It's more common in lean women, interestingly enough, and it can significantly affect quality and quantity of life. And if it's a primary source, it's usually reassurance, wear mittens, stay out in the cold.

If it's the more serious issues, sometimes they'll use topical nitroglycerin, calcium channel blockers, even medications like Viagra.

Dr. Mark Hyman
Doctor. Wow. Viagra, which is increases blood flow. That makes sense, right?

Dr. Cindy Geyer
Doctor. Yeah. Isn't that interesting? Yeah. With some benefit, right?

But I think the important thing is to say, Well, what does it actually mean, either if you have small arteries that tend to react to cold or if you've got an autoimmune condition, because that opens the door into thinking about things from a much broader comprehensive way.

Dr. Mark Hyman
Doctor. Yeah. And so from the perspective of the biology of it, you're getting these sort of contracted blood vessels. What is the cause of that?

Dr. Cindy Geyer
Well, we don't know a 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 risks, and stroke. It's really a time to pay attention to the health of your arteries.

Dr. Mark Hyman
So it could be found in isolation just as a, as a random condition, but random, or it can be associated with other autoimmune diseases that people have like Sjogren's or lupus or other conditions. And essentially, it's an almost an autoimmune disease of the blood vessels. Right? And it creates inflammation. So then the question is, you know, how do we think differently?

You know, if if you're just giving drugs like Viagra or you're giving drugs to, you know, like, blood flow, like, like, blood pressure pills and so on. What 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?

Dr. Cindy Geyer
Well, I think it's important, number one, to really do a deep dive into vascular risk measurements. We wanna know somebody's quality and quantity of cholesterol. We wanna know their glucose and insulin and how they're able to manage glucose. We wanna know their inflammatory markers, 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 cause is that's up regulating the reactivity and leading to or contributing 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.

From driving and upregulating the immune system, what we can identify and remove and address.

Dr. Mark Hyman
How do we assess people? Is there a test for Raynaud's or is it just sort of looking at the symptoms?

Dr. Cindy Geyer
Doctor. 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 these small arteries are.

You know, there's one by a company called Idamar based out of Israel called an EndoPad. 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 Yeah. Down So they can tell you about all arteries.

Dr. Mark Hyman
It's like medical torturing.

Dr. Cindy Geyer
Yeah, medical torture.

Dr. Mark Hyman
Well, that's fine. So that's good. But but then it doesn't really tell you why. Just tells you they're not working, which is you know, what we're really good at in medicine is is figuring out what's not working, but we don't know how to figure out why it's not working. You know, what's not working, but not why it's not working.

I think that's the beautiful thing about functional medicine. I've seen patients' brain nodes, when we start to dig down these issues, when we look at toxins, we look at their microbiome, we look at allergens, we look at food sensitivities, we look at infections, we can really start to bear it 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?

Dr. Cindy Geyer
Yeah. So from a diagnostic standpoint, as I mentioned before, we want to look at all those cardiometabolic risk factors. They want to look for the underlying that are up regulating 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 wanna do specifically help those arteries be more resilient less reactive. So we know, for example, that studies on meditation, yoga, biofeedback can show improvements in Raynaud's and artery elasticity after six weeks of a regular consistent practice.

Dr. Mark Hyman
Wow. Just yoga makes Right.

Dr. Cindy Geyer
That's great.

Dr. Mark Hyman
So you can basically meditate your blood vessels healthier, right? That's good.

Dr. Cindy Geyer
Yeah. What was that story years ago of somebody meditating and they could change the temperature in one hand versus the other

Dr. Mark Hyman
by five

Dr. Cindy Geyer
degrees or something incredible. Yeah. So we have more control over that autonomic nervous system than what we thought.

Dr. Mark Hyman
I've often found, find any other things around diet or supplements helpful for these patients?

Dr. Cindy Geyer
Yeah. There's a lot. So, again, food components, omega-three 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.

It's a precursor of nitroglycerin, which, of course, dilates blood vessels. Nitric oxide.

Dr. Mark Hyman
Nitric

Dr. Cindy Geyer
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 we think of that extra virgin olive oil, another food that has natural benefits on relaxing the arteries. Like

Dr. Mark Hyman
a That's that's really a lot of what I use, Cindy. I often you I'll supplement with arginine if they're very symptomatic if they're going out and often even ginkgo, which is another product. And I think the nitric oxide is interesting. You can increase nitric oxide by your breathing too. Just by practices.

We had Lou Ignarro on our podcast who won the Nobel Prize for his discovery of nitric oxide and its role in improving overall health, reducing inflammation. It's incredibly important for lung health as well. With COVID, they're finding nitric oxide being very effective treating COVID patients. 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.

That's a good thing. So maybe if you have Raynaud's, that might help as well. So arginine, you can take or you can do those drugs. Or, you know, you can actually use Inco and other things, bioflavonoids, used to use quite a bit. And combining that with the root cause, the medical detective piece, because you can't just give those it sounds like, Oh, give them arginine.

No. Well, why do they have Raynaud's? 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 Raynaud's. Use Arginine. I'm like, no. No. No.

Do you have Raynaud's? Like, what is the root cause? And this is the part that we often miss in medicine. And that's why at the Ultra Walnut Center, we really have such a robust practice because we are the medical detectives looking for the root cause. You know, I and I'll just tell you I'll tell you, 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 ticket 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 a doctor was nothing you can do, take these drugs, whatever. So I said, well, what was it like? What was happening? You get infections?

Did you have this? You have that. So I started digging into a story and tons of infections and slapping. 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.

Don't forget what it stands for. It's been so long. And and and that is associated with strep infections that cause behavior issues, OCD, ticks. And when I checked his labs, he had super high antibodies to strep. 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 taken disorders or whether it's Raynaud's or whatever, you you you 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. It'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 a cookbook protocol that is in 2021 for XYZ disease. Functional medicine is different.

We have to start thinking. We call it thinking and linking. You know, like, oh, we know why you're we go, why we know why your your fingers get cold and turn white and you have no circulations because you have Raynaud's. Like, no. That's just the name of of what it looks like.

That's just 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.

One of the first principle, the first pillar is eat real food, Real whole food. Understand that food is medicine. It's not just energy or calories. It's truly medicine. It's information.

It's instructions. It's code that learning programs your biology with every bite. It regulates your gene expression, your hormones, your brain chemistry, your immune system, your microbiome. Pretty much everything is controlled by food. And if you're eating a wrong food, you're sending all the wrong messages.

If eat the right food, you're turning on the right method. So maybe the ten day detox, you're basically taking out the bad stuff and putting it in the good stuff. You're taking all the foods that cause inflammation, that are are toxic, to your system, that are inflammatory, invest with your gut, and you're putting in foods that actually help reset your system. And it's pretty much a very simple approach. It's lots of veggies, so mostly veggies, lots of good fat, lots of fiber, lots of good clean protein.

And what does that look like? It's tons of nonstarchy veggies like broccoli, any kind of veggie you think of that's not a basically a potato. You know, sometimes sweet potatoes are okay for people. Avocado, with good shots of avocado, olive oil, nuts and seeds, lots of good protein, grass fed, organic, regenerative meats, fish, chicken. Sometimes we you know, for vegetarians, we can or vegans, we can use plant based proteins like, tempeh or or non GMO organic soy tofu.

Those are the most dense sources of protein, but you do need protein as you detoxify. So for the ten days, you're gonna be getting rid of all the other junk. Right? Processed food, other carbs, sugar, dairy, coffee, gluten, alcohol, pretty much actually all grains and beans. And the reason we get rid of the grains and beans, they're necessarily all bad, is a lot of people have issues.

A lot of people have issues with their gut. A lot of people have issues with inflammation. A lot of people have issues with gluten. A lot of people have issues with insulin resistance and prediabetes and obesity, and they can be problematic for these people. So basically, off all the bad stuff.

Now it's not calorie counting. You can eat as much as you want. We're not like crazy, well, how much macronutrients and percent of this and percent of that. No. It's just pick the right foods and we focus on what to eat.

You don't have to focus on how much to eat. Right? So when you look at your plate, it could basically look like this. Three quarters of it should be non starchy veggies, and I often will put two or three veggies in my dinner. I'll make mushrooms.

I'll have a a, you know, broccoli. I'll make some maybe a salad. So I have lots of veggies, and and I'll have a a portion of protein that's essentially on the sides of my palm. Four to six ounces, which is really 30 to 40 grams of protein. Now it's a good amount of protein, but you don't need that much if you're having animal protein.

It should be very generally raised, should be pasture raised chicken, wild caught fish, should be low mercury, obviously, all that. And we'll put all the show notes, lots of good fats with dinner, like avocados, nuts and seeds, olive oil in your veggies. You can even use, for example, ghee, which is a, kind of a butter, but it actually has the the inflammatory proteins removed casein and whey. It basically has just, the the fat. It's called clarified butter.

Very common. You can get my book, ten day detox diet. You can get the ten day detox diet cookbook, whatever you want. Put all the show notes and links together. I do call it the ten day detox diet, but sometimes you need to do it longer, like two weeks, three weeks, ten months, maybe even ten years, depending on the situation.

But we're gonna talk about the ten days and how powerful that can be to transform your health. Now, I find that most people have never connected the dots between how they feel and what they eat. They walk around with what I call FLC syndrome. That's when you feel like crap. And that is a big problem for people.

What do I mean by that? Well, you might be tired, sluggish, you might have brain fog, maybe I have digestive issues, reflux, heartburn, irritable bowel, maybe I have nasal congestion, sinus issues, muscle aches, joint pains, headaches, insomnia, Should I go on? Rashes, acne. I mean, it goes on and on and on. And and many of these things are caused by food.

And the only way to know is to do a total body reset. It's like hitting the reset button on your commuter when all the systems are jammed. It's a complete reboot. So how do you do a reboot? It's very powerful, and most people have never experienced this.

And this is why I love to do it with people. And I actually run programs all around the world where people can come and actually experience this. We we do programs where we have people do this just in five days, not even ten days. People have a seventy percent reduction in all symptoms from all diseases. Now, I'm gonna put in the show notes the medical symptom questionnaire that I use in my practice, which essentially gives you a score based on the degree and frequency and severity of symptoms.

So if you have a headache, is it zero meaning never or four, I get it all the time, it really bad or some version in between. And then you get a score at the end and, you know, people have a score of sixty, seventy, a 100. It should be less than 10, maybe even zero ideally. I I mean, should have the symptoms. It's not normal for human beings to suffer this much.

And that's really why I created this this book and the program, the ten day detox side, because I was doing this with my patients and seeing such incredible results. So, I do this personally, regularly. I do it at least two or three times a year, four times a year to really reset my system, to kinda get my body back on track, to get rid all the bad stuff, put in all the good stuff. Now, I'm gonna walk you through how to do this. I'm gonna teach you how to hit the reset button, reboot your system, and to optimize your biology to help your gut, to help your detox system, to help your immune system, to help reset your nervous system, and it's powerful.

So, if you wanna really see how your body can feel and get rid of what we call FLC syndrome, I would do this. Most people are like, the frog that's in cold water where you turn the heat up slowly and it starts to boil to death. We just kinda get used to it and think it's normal. These symptoms are not normal. I wanna do this with a junior high school once and the teachers are like, well, I we might have to get permission from the parents to see if it's safe.

You know, maybe they don't want their children doing this. I'm like, what is it safe to eat fruits and vegetables and nuts and seeds and protein and cut out sugar and starch and processed food? I mean, they should get a note that it's permission to eat the junk food that they have in school. It's probably the opposite. But anyway, yes, it's very safe.

Anybody can do this. And some people, by the way, you know, need more of certain things or other things, but but basically, this is a very universal approach to resetting your system. A second pillar aside from what you're eating, the food is really important. And and by the you need to approach in the morning, you need to sure you get rid of sugar and starch in the morning. Super important.

And then people start their diet their day with carbs, which is the worst thing you can do with sugar sweetened coffees, teas, cereals, muffins, bagels, breads. Second pillar are your daily habit. Essentially, involves a pattern of eating and living that puts your body back in rhythm. It helps you reset your nervous system. And and there's two really important habits as part of the ten day detox.

One is when you eat and also when you sleep. Let's talk about when you eat. Now when you eat might be as important as what you eat. So many of us don't eat in the right pattern. We tend to, you know, eat all day long.

We tend to snack. We tend to eat before bed. We snack late at night. It's kinda bad. So, basically, when you eat is very important.

Research shows that doing that can really be bad for your health, if you eat at night. So the first is make sure you give yourself at least twelve to fourteen hours between dinner and breakfast. So dinner is six, breakfast at eight, that's a fourteen hour fat. Okay? If you eat at six and then you keep snacking all night, that doesn't count.

Right? And it's the most simple form of what call time restricted eating, and it's basically getting our body a rep and getting the body to reset. And I wrote a lot about this in my book, the young forever, but but basically, there's a whole process at night that happens called autophagy and clean up and repair. You wanna give your body the ability to do that. The next is food.

Now you can do a breakfast if you're eating, you know, for example, dinner at six and breakfast at eight or so. That's a fourteen hour fast. Really important to have protein in the morning and not carbs and sugar. Also, not eating three hours before bed is really important. So most people eat and snack after dinner.

Don't do that. Have at least three hours of the time you eat and you go to sleep. That way you will lose weight. Your body can repair and heal instead of trying to digest and store the food. What about sleep?

Sleep is one of the most underrated pillars of health. It's probably even before exercise, meditation, maybe even before nutrition. Because when you don't sleep well, you're gonna eat tons of sugar and carbs. You're gonna crave more. So you wanna focus on sleep and restorative rest.

We know that getting in a routine of waking and sleeping can help with a deeper, more restful sleep. So try to pick the same bedtime every night, try to get off your screens for an hour or two before bed, keep your room or use blue blocker glasses, keep your room dark and cold, probably 65 to 68, really important because your body does much better with sleep at night. Try to relax at night with meditation, do a guided imagery, do breath work, stretching, journaling, gratitude practice, whatever you like, but do something, very important. So your evening routine should be like, set a bedtime at six to seven to ten days, turn your phone off and get it out of your bedroom, turn the TV off for at least an hour or two before you go to bed, And then use the time at night to read, to journal, to meditate, to connect with people you love, and just kinda wind down. The third pillar is extra support we need on the journey.

Right? Now, we all need nutrients. They they're called vitamins because they were vital amines, vital to life. Right? And and so we've seen a dramatic reduction in the nutrient density of our food.

Our organic matters done out of our soil, nutrients can't be extracted, foods travel long distances, we have commodity crops which are bred to actually breed out the nutrients and in the starch and, and, and, and, you know, yield. And so foods aren't as nutritious as they once were and probably ninety percent of Americans according to the government owned surveys are deficient in one or more nutrients at the minimum level to prevent deficiency. So how much vitamin D or you need to not get rickets? Not very much, like thirty units. How much you need for optimal health?

Probably three to five thousand. So we need to really probably focus on nutrients and even with a perfect diet, you know, because none of us are hunter gatherers anymore. We eat all kinds of food that we never ate and I'm a nutrient depleted. We need we need the basics. We need a basic set of supplements.

So multivitamin mineral foundational. Magnesium, a lot of us are deficient, probably forty five percent or low or deficient in magnesium, involving over 300 different enzymatic reactions. Super important, helps relax your nervous system at night, help you calm down. Also people get constipated sometimes when they change their diet, so taking magnesium citrate can help. And lastly, D.

Now, can also take fish oil, but vitamin D is really important. Vitamin D over 80% is lower, deficient in vitamin D. It's involved in so many different things in the body. So really important and it helps your mood, helps your muscle function, helps your brain, helps your energy, helps inflammation, autoimmunity, it's just super important and most of us are low. Fish oil is also important, and I I often recommend fish oil to people or omega-three fats.

So what are the program steps in the ten day detox? What should be the tip? And then we're gonna go through this. The first step is to eat from the ten day detox approved list for ten days. So eat what I'm telling you to eat.

Right? Whole foods, you can get a whole food based shake in the morning. You could add, you know, protein powder, grass fed protein if you want. I have a grass fed protein called super simple protein, but you really need to make sure you have a good breakfast. Second is, commit to daily habits.

Right? Take your designated eating window. Right? You want a twelve to fourteen overnight fast, which means eating within a ten or twelve hour window. Don't snack before bed.

Try to have the same bedtime. Get off your technology an hour or two before. Practice some active relaxation. Huge impact on your health. Step three is add in the supplements.

Now you don't have to do this, but I really encourage you to have a multivitamin, magnesium, vitamin D, and potentially fish oil. And we're gonna list which products you should take in the show notes so you have it all listed there. Also, what you should eat and what you should avoid during your ten eighty two talk. Let's go through So here's a full food list. You can you know, we're gonna have it in the show notes.

You can take it with you in the store. It's in the book, the ten day detox. It's in the ten day detox cookbook. But, essentially, here's what you should eat and what you should actually get rid of. What you should eat is protein.

You need the right protein. Right? So grass fed or regionally raised meats is great. You can have a path to raise lamb, beef, bison, venison, elk, grass fed beef, poultry is chicken, turkey, duck. All that's fine.

What you should avoid is conventionally raised chicken and poultry and and eggs and so forth. And by the can also have eggs if they're pasteurized eggs. Meat, get rid of all processed meats, deli meats, all conventionally raised feedlot meats, get rid of all that stuff. What about fish and seafood? Lots of small fish are good, big fish are bad.

Right? Big fish are like swordfish, tuna, seabass, halibut, most farm based fish are pretty bad for you. What you should be consuming are things like the I call this mashed fish, small wild salmon, sardines, anchovies, herring, mackerel, you can have black cod, shrimp, scallops, trout, all those are fine. Eggs, as I said, pasture eggs are fine. Nonorganic regular eggs are not fine.

What about nuts and seeds? Very important. Almonds, Brazil nuts, cashew nuts, hazelnuts, macadamia, pecan, pine nuts, pistachios, walnuts. All that's great. You can even cap the cow nibs, chocolate, not actually chocolate, but where chocaine comes from.

Seeds are great. Chia seeds, flax seeds, hemp seeds, pumpkin seeds, sesame seeds, sunflower seeds, pumpkin seeds, all great. Nut butter is also great. So unsweetened nut butter, so almond, cashew, pecan, macadamia, I love macadamia, walnut. Oh, that's great.

You also eat beans at their if you're a vegan and you wanna do this, you can use GMO free or non GMO tofu or tempeh as your protein. What you should avoid are nuts that are with sugar, that are cooked in oils, that are with basic candied stuff. A lot of nut butters have sugar, hydrogenated fats. Peanut butter. Peanuts, can be okay, but I would say mostly avoid peanuts because they have aflatoxin, and they often are rancid.

And so you wanna be careful with that. What about oils and fats? Well, the ones you wanna use are organic avocado oil. You can use organic coconut oil for cooking grass fed ghee. If you wanna use tallow, lard, duck fat, chicken fat, that's okay as long as they're they're, pathways or regenerative.

For salads, you can use different kinds of oils like almond oil, flax oil, hemp oil, macadamia oil, and convert to olive oil. And you can cook with olive oil, but only like tomato sauces and things like that. Things that are not high heat. Sesame oil, tahini is great as well. Great fat.

Sesame seed kind of paste, walnut oil, all the flavorful oils are not main oils. But you wanna avoid the traditional oils, all the seed oils like canola oil, partially hydrogenated oils, margarine, peanut oil, soybean oil, sunflower oil, safflower oil, trans fats, vegetable oil, vegetable shortening, all that stuff's bad. What about veggies? What should you eat? Well, you wanna stick with lots of non starchy veggies.

So or artichokes, organic if you can. I use the dirty dozen guide from the environmental working group, ewg.org. Tell you which are the clean 15, meaning you can eat them when not not organic or the dirty dozen, which you definitely not eat if they're not organic. But I love asparagus, artichokes, avocado, bean sprouts, broccoli, brussels sprouts, cabbage, cauliflower, celery, cucumber, eggplant, garlic, ginger, hearts of palm, kohlrabi, leafy greens, mushrooms of all kinds, onions, peppers, radicchio radish, rutabagas, all that kind of stuff. Stewed is great.

Lots of minerals, shallots, summer squash, tomatoes, turnips, zucchini, List goes on. We have all in there. You can have some things like sweet potatoes. I like the Japanese purple sweet potatoes, winter squash, carrots, pumpkin. All that's fine.

I mean, carrots are fine because unless you're doing carrot juice or that that's a problem. Basically, try to limit to, like, one serving, which is, like, half a cup a day. What you should be avoiding is corn and white potatoes mostly. A little you know, some of the little dingaling potatoes or the Peruvian potatoes, primal potatoes can be fine. What about dairy?

You can eat pasture raised butter or ghee, but I encourage you to get all dairy, including sheep and goat, which are mostly fine for people, but I encourage you to just get all other dairy. And if you're having we encourage you to have it. Make sure it's grass grass fed or originally raised. What about beans? Well, you can have green beans.

You can have green peas. You can have a non GMO or organic soy, just tofu or tempeh. You can have snap beans. You can have snow peas. But otherwise, definitely no no beans.

What about grains? No grains at all. So even healthy grains, quinoa, buckwheat, things like that. I agree really get off off all of that. Why?

Because it just shuts down the insulin response, helps people lose weight, reduce inflammation. Not that these are necessarily all bad, but eventually, you add them back. Basically, get rid of all all the other all grains, wheat, barley, rye, rice, amaranth, milletep, oats, everything. Get rid of it. Fruit.

Fruit can be okay, but small amounts of non hypoglycemic fruits. So organic blackberries, blueberries, cranberries, kiwi, lemons, limes, raspberries, all that's fine. Not too much. Right? You know what I mean?

Like, you know, two pounds of blueberries, but you can have a cup, half a cup a day. You wanna get rid of all the other fruit, all the high glycemic fruit, like bananas, pineapple, melons, cherries, grapes is the worst. Even foods that fruits that you think, you know, maybe good for you are actually good for you. Right? Whether it's, you know, peaches, pears, nectarines, and cherries, for example.

But you don't wanna eat them while you're on the ten day detox. You wanna really shut down the blood sugar and some response. What about sugar sweeteners? Sorry. You can sometimes have a little monk fruit or stevia you have in the shake.

We have, but generally tend to avoid all that stuff. Also, just get rid of all the other artificial sweeteners, all the sugar, all that stuff. If you have to ask, the answer is no, basically. Right? So then, what should you be drinking?

Well, lots of water, herbal tea, green tea, all this kind of caffeine. That's okay. A little green tea is fine. You know, if you get off coffee, sparkling water, mineral water, all that's fine. Oishi avoid alcohol, coffee, bottled water, potpicks, soda, obviously sugary beverages.

Basically that's the programs. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out.

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Thank you so much again for tuning in. We'll see you next time on the Doctor Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions.

Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com, and request to become a patient.

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